Fitness with "The Physio"
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GUT HEALTH CALCULATOR
This assessment ensures understanding of lifestyle factors only
This tool doesn’t replace any medical assessment.
All the references have been taken from
BMC Medicine, World Gastroenterology Organization page, BMJ open, NIH
Name
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Age
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Gender
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Male
Female
Other
Occupation
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Address
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Contact number
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HAS THERE BEEN ANY CHANGE IN YOUR WEIGHT OVER THE PAST MONTH ( UNINTENTIONAL) ?
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No
CHANGE IN WEIGHT OF 3KG OR BELOW 3KG
CHANGE IN WEIGHT ABOVE 3 KG
HOW MUCH WATER DO YOU CONSUME DAILY?
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2.5 - 3 Litres or more
Less than 1.5 Litres
Less than 1 Litre
How many meals do you have on a regular day?
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1
2
3
more than 3
HOW OFTEN DO YOU FAST?
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Occasionally
Weekly 2 times
4-6 times a month
HOW OFTEN YOU EAT OUTSIDE/PROCESSED FOODS ?
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Never
Occasionally (2-3times a week)
More often (Weekly 4-5) times
DO YOU HAVE ANY METABOLIC DISORDERS?E.G DIABETES/ THYROID/PCOS/HYPERTENSION
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No
Lifestyle disorders
Chronic Clinical disorders
HOW OFTEN DO YOU NOTICED ANY DISCOMFORT IN YOUR BOWEL MOVEMENTS?
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No
Occasionally
Often
DO YOU FEEL UNCOMFORTABLE AFTER EVERY MEAL?
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No
Feel heavy or exhausted
Bloated or nauseous
Any sign of cramp,pain or burning sensation after eating
ARE YOU IN HABIT OF CONSUMING ALCOHOL/ SMOKING/ DRUGS/ ANTIBIOTICS/STEROIDS ETC.?
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No
Occasionally
Often
DO YOU FEEL IRRITATED BY ANY PARTICULAR FOODS?
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No
To some specific foods
Every time with more than 5 different foods
DO YOU EXPERIENCE BAD TASTE OR BAD BREATH IN YOUR MOUTH AFTER CERTAIN INTERVALS?
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No
Yes
DOSE EATING SPICY & FATTY FOODS, CHOCOLATES, COFFEE, ALCOHOL, CITRUS OR HOT PEPPERS CAUSES YOUR STOMACH BURN OR ACHE?
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No
Yes
DO YOU HAVE ANY SORT OF RECTAL PAIN, DISCOMFORT OR CRAMPS IN YOUR LOWER ABDOMEN AREA?
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No
Yes
DO YOU FEEL DIFFICULTY OR PAIN WHEN SWALLOWING FOOD OR BEVERAGES?
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No
Yes
HAVE YOU RECENTLY EXPERIENCED , ANY KIND OF INFECTIONS OR CLINICAL ILLNESSES?
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No
Some general Infections (fever, cold, vomit or nausea)
Chronic illnesses (ulcer, inflammation, fissure etc)
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GUT HEALTH CALCULATOR
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