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Table 1 Twelve questions of the FSSG questionnaire

From: Clinical characteristics of elderly patients with proton pump inhibitor-refractory non-erosive reflux disease from the G-PRIDE study who responded to rikkunshito

  Questions ARD/RS
1 Do you get heartburn? RS
2 Does your stomach get bloated? ARD
3 Does your stomach ever feel heavy after meal? ARD
4 Do you sometimes subconsciously rub your chest with your hand? RS
5 Do you ever feel sick after meals? ARD
6 Do you get heartburn after meals? RS
7 Do you have an unusual (e.g., burning) sensation in your throat? RS
8 Do you feel full while eating meals? ARD
9 Do some things get stuck when you swallow? RS
10 Do you get bitter liquid (acid) coming up into your throat? RS
11 Do you burp a lot? ARD
12 Do you get heartburn if you bend over? RS
  1. RS, reflux symptom; ARD, acid-related dysmotility symptom.