Table 1 GerdQ self-assessment questionnaire
Symptoms in the | Symptom presence | ||||
|---|---|---|---|---|---|
previous week | |||||
0 days | 1 day | 2-3 | 4-7 | ||
days | days | ||||
Question: | |||||
1. | How often did you have a burning feeling behind your breastbone (heartburn)? | 0 | 1 | 2 | 3 |
2. | How often did you have stomach contents (liquid or food) moving upwards to your throat or mouth (regurgitation)? | 0 | 1 | 2 | 3 |
3. | How often did you have a pain in the center of the upper stomach? | 3 | 2 | 1 | 0 |
4. | How often did you have nausea? | 3 | 2 | 1 | 0 |
5. | How often did you have difficulty getting a good night’s sleep because of your heartburn and/or regurgitation? | 0 | 1 | 2 | 3 |
6. | How often did you take additional medication for your heartburn and/or regurgitation other than what the physician told you to take (such as Maalox)? | 0 | 1 | 2 | 3 |