The presence of symptoms compatible with irritable bowel syndrome (IBS) in patients with inflammatory bowel disease (IBD) in remission is very common, affecting approximately one third of this population, with a negative impact on quality of life. It’s pathophysiology is still unclear, and it may be due to a subclinical inflammatory activity of IBD or a superimposed “true” IBS. Understanding the origin of this condition can help with the management, reducing withdrawals and reducing the chances of mistakes in the therapeutic escalation.