How often have you had rectal urgency (felt like you had to pass stool, but did nothing) during the past 4 weeks? |
How often have you had uncontrolled leakage of stool or feces during the past 4 weeks? |
How often have you had stools (bowel movements) that were loose or liquid (no form, watery, mushy) during the past 4 weeks? |
How often have you had bloody stools during the past 4 weeks? |
How often have your bowel movements been painful during the past 4 weeks? |
How many bowel movements have you had on a typical day during the past 4 weeks? |
How often have you had cramping pain in your abdomen, pelvis or rectum during the past 4 weeks? |
How big a problem, if any, has each of the following been for you?
Urgency to have a bowel movement
Increased frequency of bowel movements
Watery bowel movement
Losing control of your stools
Bloody stools
Abdominal/ pelvic/ rectal pain
|
Overall, how big a problem have your bowel habits been for you during the past 4 weeks? |