Irritable bowel syndrome is an idiopathic clinical entity characterised by chronic (more than six months) abdominal pain that occurs in association with altered bowel habits. In 2016 the Rome IV Consensus report adjusted the diagnosis to include symptoms occurring at least once a week from a previous definition of three times a month and include the notation of abdominal pain rather than discomfort related to defaecation. In practical terms, irritable bowel syndrome is in part a diagnosis of exclusion, however, in younger patients without alarm symptoms a simple stool test for calprotectin rather than extensive endoscopic work up may be all that is required. A negative calprotectin favouring conservative and symptomatic management, a positive finding requiring further workup.