OBJECTIVES: To explore disease burden, economic impact, treatment landscape and unmet medical needs in patients with IBS-C METHODS: We conducted a review of MEDLINE- and EMBASE-indexed and `grey’ literature (citeable material that is often not published in peer-reviewed, indexed medical journals, e.g.,web-based international treatment guidelines) published in the last decade (January 2000 to December 2010) pertaining to the epidemiological, clinical, economic, and humanistic impact of IBS-C with a European country focus (France, Germany, Italy, Spain, UK). RESULTS: Altogether 885 unique studies were identified; 106 were included in the analysis. Among patients with IBS, the prevalence estimates of IBS-C range from 24% to 44%. Comorbid conditions such as personality and psychological traits and stress,   are common. Patients with IBS-C have lower health-related quality of life (HRQoL) compared with the general population (18 studies); treatment of IBS-C can improve HRQoL. The European societal cost of IBS-C is largely unknown; no European cost-of-illness (COI) studies were identified specifically on IBS-C. In the absence of European data, US data show IBS-C to be cost-intensive. Two cost analyses demonstrated the substantial societal impact of IBS-C, with adult patients experiencing reduced productivity at work or through work absenteeism (mean number of days off work annually: 8.5 to 21.6 days) due to severe, disruptive symptoms. European and local IBS treatment guidelines (where available) offer similar diagnostic/management recommendations; however, IBS-C treatment varies by country. Current monotherapy options for treating IBS-C are suboptimal. 5-HT4 agonists have been evaluated for IBS-C; however, they have been associated with ischaemic colitis or a lack of substantial benefit in IBS-C versus placebo. CONCLUSIONS: Our literature search indicates a lack of monotherapy treatment options to adequately manage IBS-C patients, and the need for European focussed burden of disease and COI studies, to address the evidence gaps identified in this systematic literature search.