Symptoms of irritable bowel syndrome (IBS) are common in patients with inflammatory bowel disease (IBD). Because of the overlap of these symptoms with those associated with the underlying inflammation, a major debate has ensued as to whether these IBS-like symptoms are truly IBS or related to the inflammation itself. This argument has therapeutic implications. Therapy to minimise and resolve inflammation should be applied where inflammation is present (e.g., faecal calprotectin levels are elevated), but, in reality, IBS-like symptoms often continue despite this and are often present when active inflammation cannot be identified. While high quality evidence about managing such symptoms is missing, the clinical approach involves utilising similar strategies as for a patient with IBS. One of those is reducing FODMAP intake. Published experience indicates similar efficacy for reducing symptoms as in IBS when patients with quiescent disease are treated. The responses appear to be durable. Restriction of FODMAP intake can also reduce the frequency of ileal pouch emptying and the volume of ileostomy output. Despite such promise, issues/risks associated with dietary restriction per se and specifically with the diet should be specially considered. For example, challenging nutritional adequacy in a patient population already with or at risk of undernutrition should be addressed in the individual. The effect of the low FODMAP diet on the microbiota is of theoretical concern since the natural prebiotic effect of oligosaccharides will be reduced and dysbiosis is considered a pathogenic factor in many patients with IBD. The actual FODMAP intake of patients with IBS requires investigation, especially since fructan intake appears to be reduced at least in association with active Crohn’s disease. Thus, the low FODMAP diet may have efficacy in symptom management for patients with IBD, but its implementation does require care, preferably with dietetic supervision.