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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.