OBJECTIVES: To describe the population of moderate-to-severe IBS-C patients in French clinical practice and to compare the main data with the European data from the IBIS-C study. The IBIS-C study was conducted in six European countries (France, Germany, Italy, Spain, Sweden and UK). METHODS: Observational, retrospective-prospective (6 months each) study of patients diagnosed (Rome-III criteria) in the last five years and moderate-to-severe IBS-C severity at inclusion (IBS-Symptom Severity Scale [IBS-SSS] score ≥175). Healthcare resource utilisation (HRU) was retrospectively and prospectively assessed and quality-of-life (QoL) was assessed at baseline with IBS-QoL and EuroQoL-5D (EQ-5D). RESULTS: Patient characteristics were similar between the French (n= 59) and European (n=525) cohorts: mean (±SD) age 47.7±15.7 and 45.3±15.8 years; 83% and 87% were female, and 63% and 60% had severe IBS-C. Mean symptom duration: 13.5±13.5 and 12.8±13.1 years; mean time since diagnosis: 2.6±6.3 and 3.0±5.2 years. At baseline, mean IBS-QoL was 42.9±19.0 and 54.9±22.7 (scale: 0-100[worst-best]); mean EQ-5D was 46.6±22.2 and 55.5±21.7 (scale: 0-100[worst-best]). Over follow-up, 76% French and 73% European patients consulted a GP (mean: 4.2 and 4.9 visits), and 100% and 92% a gastroenterologist (mean: 2.2 and 2.8 visits). 17% and 18% required emergency department visits/hospitalisation (mean stay: 6±6 and 14±24 days). 51% and 65% of patients took prescription drugs for their IBS-C, 61% and 67% took non-prescription drugs. Mean symptom severity (IBS-SSS) improved: 338.9±78.6 (baseline) to 281.5±102.1 (6 months) for the French cohort; 323.2±84.3 to 253.9±105.6 for the European cohort. The total mean (95%CI) annual cost for moderate-to-severe IBS-C was €4,128 (2,262-6,633) for the French cohort; €4,639 (3,733-5,598) for the European cohort. CONCLUSIONS: Moderate-to-severe IBS-C symptoms in France were similar to those other European countries. QoL impairment and HRU were high for both cohorts. Moderate-to-severe IBS-C continued to be a burden for both cohorts with a high economic cost despite availability of therapeutic interventions.