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Gut Symptoms Questionnaire
Please read each question and tick a response for each to the best of your ability.
YES
NO
I experience bloating on a daily basis
I wake up feeling bloated in the morning
My bloat gets progressively worse throughout the day
I am intolerant to dairy or gluten
I suffer from gastroesophageal reflux disease (GERD)
I take medication for GERD
I have a reduced appetite
I feel nauseous on a daily basis
I find it difficult to digest animal protein
I get toilet urgency after eating
I have loose stools / diarrhoea most days
I have more > 3 bowel movement a day
I have detected mucous or blood in my stool
I frequently experience cramping
I suffer with intestinal pain most days
I find it hard to have a bowel movement
I take laxatives in order to have a bowel movement
I have < 1 bowel movement a day
I feel a sense of incomplete evacuation when I have a bowel movement
I feel gassy and have a lot of flatulence
I am intolerant to many foods
I have known food sensitivities
I tend to eat a lot of processed / junk food
I tend to eat a healthy whole-food based diet
I have experienced gut issues for > 5 years
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