A Quick BTB IBS Survey

Birthday*

1. In the last 3 Months, how often have you had abdominal pain?*

2. Is your abdominal pain typically related to a bowel movement?*

3. Over the past three months, have you noticed a change in the frequency of your bowel movements?*

4. Over the past three months, have you noticed a change in the appearance (form) of your stool?*

5. On a day when you have abnormal bowel movements, what type do you have most often?*