A new article published in Panminerva Medica discussed that irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder which presents with abdominal pain associated with alteration of bowel habits. The authors reported that IBS affects 9-23% of the general population, of which 80% are females, causing considerable impact on the quality of life and health care costs. However, the exact pathogenesis of IBS remains obscure and is said to be multifactorial involving environmental and host factors. Management of patients with IBS is challenging since its diagnosis and treatment may require several approaches with unsatisfactory results. It was stated that the diagnosis of IBS is based on the positive identification of symptoms and by excluding an underling organic disease. Before choosing therapeutic options, a strong reassuring physician-patient relationship is crucial. Therapeutic approach of IBS may comprise both non-pharmacological therapies and pharmacotherapy and should be based on prevalent symptomatology. Lifestyle modifications such as stress reduction and increased physical activity appear to be useful in improving symptoms and should be encouraged. Dietary modifications represent an important first-line therapeutic option. Furthermore, pharmacological treatment should take into account the predominant symptom and test one drug at a time with a predefined time point for effectiveness evaluation and dosage adjustment.