Gut Health Questionnaire

HomeGut Health Questionnaire

Want to find out your Good Gut Health Score?

Is your gut fibre fit enough? Get to know your gut by answering just few simple questions.


What is your Gender?

Male

Female

Other

How old are you?

20-30 years

30-40 years

40-50 years

How often are you bothered by gut symptoms, e.g. bloating, reflux, constipation?

1-3 times in a week

1-3 times in a month

Less than once a month

How often do you take antacids or other stomach related over-the-counter drugs?

Regular

Sometimes

Rarely

Is your stool easy to pass?

It is always difficult

Sometimes

Rarely

Do you have urgency with your bowel movements?

Regular

Sometimes

Rarely

Do you experience any bloating or distention?

Regular

Sometimes

Rarely

How often do you find it hard to go off to sleep after hitting bed

Regular

Sometimes

Rarely

There has been a persistent change in my bowel habit, which cannot be explained by stress, changing my diet, medications or going away.

Frequently, Most of the times

Sometimes

Rarely

Have you experienced persistent abdominal pain, which is not related to changing my diet or stress.

Frequently, Most of the times

Sometimes

Rarely

Have you lost appetite and/or feel sick frequently for no obvious reason?

Frequently, Most of the times

Sometimes

Rarely

When did you take antibiotics last

Within 1 month

Within 3 months

Within 6 months or more

How often do you use alcohol and/or drugs?

Regularly

Ocassionally

Never

How often do you exercise?

Never

2-3 times in a week

Everyday

How often do you experience abdominal bloating?

Regularly

Sometimes

Never

How often do you feel that your bowel has not been emptied after a bowel movement?

Regularly

Sometimes

Never

How often do you feel uneasy after a regular-sized meal?

Regularly

Sometimes

Never

When did you take steroids medication last

Within 1 month

Within 3 months

Within 6 months or more

Never

When did you take Psychosomatic medicines (Antidepressants, Anti Anxiety medications)

Within 1 month

Within 3 months

Within 6 months or more

Never

Do you get migraines or headaches ?

Frequently, Most of the times

Sometimes

Rarely

Are you interested in joining our 21 days Gut Health Program

Yes

No

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