Leaky Gut Syndrome Questionaire

HomeLeaky Gut Syndrome Questionaire


Welcome to your Leaky Gut Syndrome Questionnaire
This questionnaire has been reprinted from Dr. Elizabeth's Lipski's book, Leaky Gut Syndrome.
Circle the number that mostly fits.

1 = Symptom is not present or rarely present

2 = Mild/sometimes

3 = Moderate/often

4 = Severe/almost always
Constipation and/or diarrhea1234
Abdominal pain or bloating1234
Joint pain, swelling, arthritis1234
Chronic or frequent fatigue or tiredness1234
Food allergies, sensitivities or intolerance1234
Sinus or nasal congestion1234
Chronic or frequent inflamations1234
Eczema, skin rashes or hives, asthma, hay fever, or air borne allergies1234
Confusion, poor memory or mood swings1234
Use of NSAIDS (Aspirin, Tylenol, Motrin)1234
Alcohol consumption makes you feel sick1234
Ulcerative colitis, Crohn's or Celiac disease1234

WHY IS IT IMPORTANT TO KNOW IF YOU HAVE A LEAKY GUT?

Symptoms of leaky gut are related to local inflammation of the intestines and include abdominal pain, bloating, excess gas, increased food sensitivies and chronic diarrhia or constipation. More widespread effects might include general aches and pains.

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