Gastrointestinal History |
Yes / No |
| Do you have gnawing pain / burning in the stomach? |
N |
|
N/A |
|
N/A. |
| What types of food do you avoid? |
None |
| Have you ever vomited up blood? |
N |
| Any recent change in bowel habits? |
N |
| Frequency of loose bowel movements? |
N/A |
| Problems with constipation? |
N |
| Ever have black tarry bowel movements? |
N |
| Excessive gas in your stomach? |
N |
| Ever had bright red bleeding from the rectum? |
N |
| Do you have pain with bowel movements? |
N |