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Katie AI
Wellness Analyst
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Part 2: Digestive
Step
1
of 8
Abdominal Pain Severity
Rate the severity of any abdominal pain you maybe experiencing? (SSS1)
Select
0 (none)
3 (mild)
6 (moderate)
10 (severe)
0 (Don’t Know)
Rate the frequency of any abdominal pain you maybe experiencing? (SSS2)
Select
0 (rarely or never)
3 (occasionally)
6 (often)
10 (most or all days)
0 (Don’t Know)
Do you experience bloating or gas in your abdomen (SSS3)?
Select
0 (no)
3 (mild or occasional)
6 (moderate or frequent)
10 (severe or almost constant)
0 (Don’t Know)
How often do you experience diarrhea or constipation or a cycle of both (SSS4)?
Select
0 (never or rarely)
3 (occasionally, 1-3 days a week)
6 (often, 4-6 days a week)
10 (almost always or always)
0 (Don’t Know)
Life Impact
Do bowel and abdomin problems affect your daily life? (SSS5)
Select
0 (no)
3 (mild impact)
6 (moderate impact)
10 (severe impact)
0 (Don’t Know)
Does any stomach pain get better after a bowel movement?
Select
0 (No)
5 (Sometimes)
10 (Yes)
0 (Don’t Know)
Do you have changes in stool form (hard/lumpy or loose/watery) when you have stomach pain?
Select
0 (No)
5 (Yes, harder/lumpier)
5 (Yes, looser/watery)
10 (Yes, alternating)
0 (Don’t Know)
How often do you feel like you still need to go after a bowel movement?
Select
0 (Rarely or Never)
3 (Occasionally)
6 (Often)
10 (Almost Always)
0 (Don’t Know)
History & Digestion
Do you have a family history of IBS or gastrointestinal disorders?
Select
0 (No)
5 (Yes)
0 (Don’t Know)
Have you been diagnosed with IBS?
Select
No
Yes
Does bloating get worse after eating carbohydrates?
Select
No
Sometimes
Yes, significantly worse
Don’t Know
How often do you experience severe bloating?
Select
Never
Sometimes
Often
Digestive Comfort
Do you have very bad gas?
Select
No
Yes
Do you frequently experience motility issues such as indigestion, bloating, feeling full quickly, nausea, constipation?
Select
No
Yes, suspected
Yes, diagnosed
Don’t Know
Have you become sensitive to lots of foods?
Select
No
Yes
Unsure
Medications
Do you have a history of chronic antibiotic use?
Select
No
Yes, once in past year
Yes, multiple times/chronic
Don’t Know
Have you taken PPI for an extended period (more than 1 month)?
Select
No
Yes, in the past
Yes, currently
Don’t Know
What has been the impact of Antibiotics on your motility issues?
Select
Not taken antibiotics
Symptoms worsened
Symptoms stayed the same
Symptoms improved
Don’t Know
Immune Health
Do you have iron-deficiency anemia, even though you get enough iron?
Select
No
Yes, in the past
Yes, currently
Don’t Know
Have you been diagnosed with osteoporosis or osteopenia before age 50?
Select
No
Yes, suspected
Yes, diagnosed
Don’t Know
Family history of celiac disease, autoimmune disorders, or other digestive conditions?
Select
No
Yes, one 1st-degree relative
Yes, multiple 1st-degree relatives
Don’t Know
Do you have or ever had, an itchy rash with blistering on your joints or torso for more than a few weeks?
Select
No
Yes, suspected
Yes, diagnosed
Don’t Know
Reactions & Stools
Have you tried a gluten-free diet that improved stomach problems?
Select
Not tried GFD
No improvement
Slight improvement
Significant improvement
Don’t Know
Are stools often loose or bulky?
Select
No
Yes
Have you lost weight without trying?
Select
No
Yes
Do you experience constant and unexplainable fatigue?
Select
No
Yes
Dairy & Safety
Do you regularly experience gas, bloating or diarrhea after consuming dairy products (like milk, cheese, and yogurt)?
Select
No
Sometimes
Yes
Don’t Know
Have you tried a dairy-free diet and it improved gastro problems?
Select
Not tried LFD
No improvement
Slight improvement
Significant improvement
Don’t Know
Do symptoms start within 2 hours of dairy?
Select
No
Yes
Unsure
Problems after small amounts of dairy?
Select
No
Yes
Have you noticed blood or blood and mucous in your stools?
Select
No
Yes
