Table 1 GerdQ questionnaire template
Question | Frequency score (points) for symptoms | |||
|---|---|---|---|---|
0 day | 1 day | 2–3 days | 4–7 days | |
1. How often did you have a burning feeling behind your breastbone (Heartburn)? | 0 | 1 | 2 | 3 |
2. How often did you have stomach contents (liquids or food) moving upwards to your throat or mouth (regurgitation)? | 0 | 1 | 2 | 3 |
3. How often did you have pain in the centre of the upper stomach? | 3 | 2 | 1 | 0 |
4. How often did you have nausea? | 3 | 2 | 1 | 0 |
5. How often did you have difficulty getting a good nights sleep because of your heartburn and / or regurgitation? | 0 | 1 | 2 | 3 |
6. How often did you take additional medication for your heartburn and / or regurgitation, other than what your doctor told you to take (e.g. Gaviscon, Rennie) | 0 | 1 | 2 | 3 |