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. 2004 Mar;53(3):368–370. doi: 10.1136/gut.2003.025643

Table 1.

Questions asked when interviewing patients before and after biofeedback treatment

Question Before After
How often do you open your bowels? (per week/per day)
How often do you try to open your bowels in a day but without any result?
How long do you spend in the toilet on each visit when trying to open your bowels?
During each visit to the toilet, for what proportion of the time do you strain? (%)
Do you pass blood from your back passage?
Do you pass mucus from your back passage?
Do you put a finger into your back passage to help to empty stool?
Do you put a finger into your vagina to help to empty stool?
Do you ever have the feeling that you have not completely emptied your bowels?
Do you ever experience any soiling or leaking from your back passage that you cannot control?
Do you experience any abdominal bloating?
Do you experience any pain around your back passage?
Are you taking laxatives, suppositories or enemas? (If yes please list on the reverse of this sheet)
Are you taking any other medication?