Self-Assessment Questionnaires

I find food that is not fully digested in my stool.

I have food allergies, intolerance, or reactions.

I have canker sores.

I crave sweets and bread.

I drink more than 3 alcoholic beverages a week.

I frequently use or have frequently used antibiotics in the past (more than 1-2 times in 3 years).

I have a history of NSAID (ibuprofen, naproxen, etc.) or other anti-inflammatory use.

I have taken birth control pills or hormone replacements/have taken birth control pills or hormone replacements.

Loss of taste for meat.

Lower bowel gas several hours after eating.

Burning stomach sensations, eating relieves.

Coated tongue.

Pass large amounts of foul-smelling gas.

Indigestion 1/2 - 1 hour after eating; may be up to 3-4 hours.

Mucous colitis or "irritable bower".

Gas shortly after eating.

Stomach "bloating” after eating.

Location