Male Questionnaire
Page 2(g) of 9

← You are on page 2g of 9
Report by The Analyst™
Click to see sample report

Click here if you have already started the questionnaire and would like to continue.

Click here to start the questionnaire and receive your own detailed health analysis.

This section covers specific bowel / intestinal problems.


Have you had Ulcerative Colitis?
  • Never / don't know
  • Mild / moderate but in remission
  • Serious, but in remission
  • Yes, currently mildly / moderately active
  • Yes, currently seriously active


Have you had Crohn's Disease?
  • Don't know
  • No, it has been ruled out
  • Moderately, but in remission
  • Seriously, but in remission
  • Yes, currently active


Have you been diagnosed with Diverticular Disease?
  • Don't know
  • No, it has been ruled out within the past 2 years
  • It is suspected
  • Confirmed 1 or 2 pockets
  • Confirmed 3 or more pockets


Have you had Dysentery?
  • Never had it / don't know
  • Single episode in past only
  • Multiple or prolonged episodes in past only
  • Very significant episode within the last 6 months
  • Very significant current problem


Have you been diagnosed with Irritable Bowel Syndrome (IBS)?
  • No / don't know
  • Mild, in the past, now resolved
  • Serious, in the past, now resolved
  • Current minor/moderate problem
  • Current major problem


Have you had any polyps in your colon?
  • Don't know
  • No, none have been found during examination
  • Yes, it/they were removed
  • One or two present
  • More than two present


Have you suffered from Hemorrhoids?
  • Never had one / don't know
  • Probably had one/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem


Does your anus itch?
  • Never / very rarely / don't know
  • Occasionally - a few times a month
  • Often, mostly at night
  • Often, day and night