GUT HEALTH ASSESSMENT

Complete the following questions for an assessment of your gut health.

This questionnaire is taken from recognised, validated medical questionnaires and additional questions that will help give a more complete picture of your gut health.

You may find some questions a little embarrassing - but as a gastrointestinal surgeon, I ask these questions of patients every day, so don't be shy about answering!

We will discuss the results in our gut health modules but if you would like a copy of the results, please enter your email address at the end.
GUT OR STOMACH SYMPTOMS
This part of the questionnaire relates to gut symptoms over the PAST WEEK. Please choose the answer that best applies to you.
Have you been bothered by PAIN OR DISCOMFORT IN YOUR UPPER ABDOMEN OR THE PIT OF YOUR STOMACH during the past week?*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by HEARTBURN during the past week? (By heartburn I mean an unpleasant stinging or burning sensation in the chest.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by ACID REFLUX during the past week? (By acid reflux I mean the sensation of regurgitating small quantities of acid or flow of sour or bitter fluid from the stomach up to the throat.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by HUNGER PAINS in the stomach during the past week? (This hollow feeling in the stomach is associated with the need to eat between meals.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by NAUSEA during the past week? (By nausea I mean a feeling of wanting to throw up or vomit.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by RUMBLING in your stomach during the past week? (Rumbling refers to vibrations or noise in the stomach.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Has your stomach felt BLOATED during the past week? (Feeling bloated refers to swelling often associated with a sensation of gas or air in the stomach.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by BURPING during the past week? (Burping refers to bringing up air or gas from the stomach via the mouth, often associated with easing a bloated feeling.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by PASSING GAS OR FLATUS during the past week? (Passing gas or flatus refers to the need to release air or gas from the bowel, often associated with easing a bloated feeling.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by CONSTIPATION during the past week? (Constipation refers to a reduced ability to empty the bowels.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by DIARRHOEA during the past week? (Diarrhea refers to a too frequent emptying of the bowels.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by LOOSE STOOLS during the past week? (If your stools (motions) have been alternately hard and loose, this question only refers to the extent you have been bothered by the stools being loose.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by HARD STOOLS during the past week? (If your stools (motions) have been alternately hard and loose, this question only refers to the extent you have been bothered by the stools being hard.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
Have you been bothered by an URGENT NEED TO HAVE A BOWEL MOVEMENT during the past week? (This urgent need to go to the toilet is often associated with a feeling that you are not in full control.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
When going to the toilet during the past week, have you had the SENSATION OF NOT COMPLETELY EMPTYING THE BOWELS? (This feeling of incomplete emptying means that you still feel a need to pass more stool despite having exerted yourself to do so.)*

No discomfort at allMinor discomfortMild discomfortModerate discomfortModerately severe discomfortSevere discomfortVery severe discomfort
YOUR RESULTS

Thank you. Here are your results in different areas of gut health, which are scored from 1-7, according to severity of symptoms.

We will discuss these areas, but you can repeat the questions later in the programme to see if there is any improvement.
Your reflux score is
Your abdominal pain score is
Your indigestion score is
Your diarrhoea score is
Your constipation score is
Your GSRS score is
BOWEL HABIT
This part of the questionnaire gets a bit more personal! But, as a gastrointestinal surgeon it is routine for me to ask these questions, so don't be shy!
What is your usual bowel habit? (This means how often you have a poo.)

I open my bowels 4 or more times a day.I open my bowels 1-3 times a day.I don't open my bowels every day but I open my bowels 3 times a week or so.I open my bowels less than 3 times a week.
WHAT DO YOUR RESULTS MEAN?

Everyone is different in how often they open their bowels. Anything from 1-3 times a day to 3 times a week is normal.

Opening your bowels 4 times a day or more suggests a gut health problem - there are various reasons that this could occur which will be discussed.

Opening your bowels less than 3 times a week also suggests a problem - likely inadequate fibre in your diet, but other causes are also worth considering.
The image below may seem a bit gross but is a medically validated assessment of the variation in stool (poo) type that can suggest gut problems. Take a look at the image and record which stool (poo) type you most commonly pass. Choose the best answer for you.

Type 1Type 2Type 3Type 4Type 5Type 6Type 7Impossible to say as it can vary from day to day between type 1/2 to type 5-7
WHAT DO YOUR RESULTS MEAN?

Types 3 and 4 are normal.

Types 1-2 suggest constipation.

Types 5-7 are looser stools than we would normally expect, and can occur for various reasons.

Alternating from one extreme to another may suggest irritable bowel syndrome. We will discuss this.
FOOD INTOLERANCE
Have you noticed any gut symptoms after eating apples, mangos, pears, watermelon, honey, high-fructose corn syrup or agave?*

YesNo
Have you noticed any gut symptoms after dairy products (products made from milk from cows, goats, or sheep), custard, yogurt or dairy ice cream?*

YesNo
Have you noticed any gut symptoms after eating products made with rye and wheat, or with vegetable such as asparagus, broccoli, cabbage, onions or garlic?*

YesNo
Have you noticed any gut symptoms after eating legumes, such as beans (including baked beans), lentils, chickpeas, and soybeans?*

YesNo
Have you noticed any gut symptoms after eating fruits that have pits or seeds, such as apples, apricots, avocados, cherries, figs, peaches, pears, or plums*

YesNo
WHAT DO SYMPTOMS FROM THESE FOODS MEAN?

Symptoms after a variety of these foods may be due to an intolerance to FODMAP foods. FODMAP foods are a certain type of food that contains Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols which can trigger bloating and other gut symptoms in some people. We will discuss this issue in more detail.

The absence of symptoms from foods like this suggests a healthy gut in that respect.
Dairy intolerance, specifically, may be due to lactose intolerance or an intolerance or even an allergy to milk protein. It may also be part of a general intolerance to FODMAP foods.
Symptoms after eating wheat-based products, specifically, may reflect a gluten intolerance or even coeliac disease. Or they may be part of a general intolerance to FODMAP foods.
CANCER CHECK
Have you had a qFIT bowel cancer test in the past 2 years?*

YesNo
Have you had a colonoscopy or CT colonogram in the past 2 years? (telescope or CT scan check of bowel)*

YesNo
You should consider having a regular check of your bowels to exclude polyps that can be removed before they potentially turn cancerous. 1 in 18 women will have bowel cancer in their lifetime - don't let it be you.

qFIT tests are available every 2 years from the NHS from the age of 60, or 50 in some areas. However, bowel cancer rates are increasing in younger people.

If you would like to use this simple and accurate test but can't access it on the NHS, please visit www.b-assured.com to purchase one.
We will discuss all of the above in our gut health module. Please enter your name and email address below to receive a copy of your results - make sure your details are correct! Check your spam folder too, if you don't get an email.
Name*

First NameLast Name
Email*
example@example.com
All done! Now press the SUBMIT button below.

If you don't get taken to a thank-you page, check back that you have filled in all fields and SUBMIT again.
Should be Empty:

GUT OR STOMACH SYMPTOMS

BOWEL HABIT

FOOD INTOLERANCE

CANCER CHECK

All done! Now press the SUBMIT button below.