E
Edward
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Estimated Life Expectancy :
80
Yrs
Digestive History
Do you associate any digestive symptoms with eating certain foods?
No
Could you please explain any digestive symptoms, if any, you experience from eating certain foods?
Digestive symptoms, if any, you experience from eating certain foods
How often do you have a bowel movement?
Less than once a day
Once a day
More than once a day
If you take laxatives, what type/brand and how often?
laxatives type/brand daily
How would you describe your stools?
Hard
Soft
Loose
Please indicate how often you experience the following symptoms:
Often
Sometimes
Rarely
Heartburn
Gas
Bloating
Stomach Pain
Nausea/Vomiting
Diarrhea
Constipation
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Next
Do you associate any digestive symptoms with eating certain foods?
Yes
No
Could you please explain any digestive symptoms, if any, you experience from eating certain foods?
digestive symptoms, if any, you experience from eating certain foods
How often do you have a bowel movement?
Less than once a day
Once a day
More than once a day
If you take laxatives, what type/brand and how often?
How would you describe your stools?
Hard
Soft
Loose
Please indicate how often you experience the following symptoms:
Often
Sometimes
Rarely
Heartburn
Gas
Bloating
Stomach Pain
Nausea/Vomiting
Diarrhea
Constipation
Save