Is Your Ulcerative Colitis Treatment Working?

Health Writer

Question 1 of 10

Over the past week, how many bowel movements have you had (on average) per day?

A1-2
B4-6
C7-9
DMore than 9
A1-2
B4-6
C7-9
DMore than 9
NEXT
Question 2 of 10

Over the past week, how many bowel movements have you had per night that woke you up?

A1-3
B4-6
CMore than 6
A1-3
B4-6
CMore than 6
NEXT
Question 3 of 10

Over the past week, how often have you seen blood in your bowel movements?

ANone of the time
BLess than half of the time
CAt least half of the time
DAt least half of the time AND passage of at least one bowel movement with blood alone
ANone of the time
BLess than half of the time
CAt least half of the time
DAt least half of the time AND passage of at least one bowel movement with blood alone
NEXT
Question 4 of 10

Over the past week, how urgent have your bowel movements typically been?

ANot urgent at all
BSomewhat urgent (i.e., in a hurry to find a toilet)
CExtremely urgent (i.e., need to have a toilet nearby)
DIncontinent (i.e., no control)
ANot urgent at all
BSomewhat urgent (i.e., in a hurry to find a toilet)
CExtremely urgent (i.e., need to have a toilet nearby)
DIncontinent (i.e., no control)
NEXT
Question 5 of 10

Which of the following best describes your typical stool consistency over the past week?

AFormed
BSemi-formed
CLiquid
AFormed
BSemi-formed
CLiquid
NEXT
Question 6 of 10

Which of the following best describes your abdominal pain over the past week?

ANone or occasional mild pain
BPain typically occurs before and/or after bowel movements but is minimal at other times
CPain is prolonged and/or severe
ANone or occasional mild pain
BPain typically occurs before and/or after bowel movements but is minimal at other times
CPain is prolonged and/or severe
NEXT
Question 7 of 10

How frequently do your ulcerative colitis symptoms limit your ability to work, go to school, or engage in social activities?

ANever
BOccasionally
CFrequently
DAlways
ANever
BOccasionally
CFrequently
DAlways
NEXT
Question 8 of 10

How many extraintestinal (outside of the intestines) symptoms related to ulcerative colitis do you have? Common symptoms include arthritis; skin rash; inflammation of the liver or biliary tract; eye inflammation; osteoporosis; peripheral neuropathy; kidney stones; gall stones; and nutrient deficiencies.

A0
B1
C2 or more
A0
B1
C2 or more
NEXT
Question 9 of 10

How would you describe your general well-being over the past week?

AVery well or better than normal
BClose to normal
CSlightly worse than normal
DConsiderably worse than normal
EMuch worse than normal
AVery well or better than normal
BClose to normal
CSlightly worse than normal
DConsiderably worse than normal
EMuch worse than normal
NEXT
Question 10 of 10

How frequently do you worry or feel anxious about your ulcerative colitis? For example, you may have concerns about developing cancer, worries about the inability to resolve symptoms, and anxieties about relapses.

AAll of the time
BMost of the time
CSome of the time
DHardly any of the time
ENone of the time
AAll of the time
BMost of the time
CSome of the time
DHardly any of the time
ENone of the time
NEXT
Complete all questions to see your results