FODMAP Challenge Post-survey Post Survey - How you feel Survey for participants to fill in prior to commencing The FODMAP Challenge Step 1 of 4 - Basic Information 25% Name:* Email:* Age*18-2930-3940-4950-5960+Do you give permission for us to use the information provided in this survey for research purposes? All data used will be de-identified.* Yes No Section AThe following questions ask you about your abdominal and bowel symptoms. When we use the word abdomen we mean belly/tummy. Some of the questions ask about passing a stool. By this we mean going to the toilet for a reason other than to urinate (pass water). All of these questions refer to the last 4 weeks. This portion of the survey is included with thanks to Andrea Roalfe, Lesley Roberts and Sue Wilson of the Department of Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham 1. During the last 4 weeks, how often have you had discomfort or pain in your abdomen?* All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 2. How often have you been troubled with loose, mushy or watery bowel motions during the last 4 weeks? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 3. How often during the last 4 weeks have you been troubled with diarrhoea?* All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 4. During the last 4 weeks how often have you been troubled by hard bowel motions?* All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 5. During the last 4 weeks how often have you felt the need to strain to pass a motion (stool)? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 6. During the last 4 weeks how often have you been troubled by constipation? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 7. During the last 4 weeks how often did you experience pain or discomfort in your abdomen after eating? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 8. How often has you abdominal pain prevented you from sleeping, or woken you during the night during the last 4 weeks?* All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 9. During the last 4 weeks how often have you leaked or soiled yourself?* All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 10. How often during the last 4 weeks have you suffered from a feeling of urgency (feeling that you must immediately rush to the toilet to pass a stool)? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time 11. How often have you passed mucus or slime in your stools over the last 4 weeks? All of the time Most of the time A good bit of the time Some of the time A little of the time None of the time Section BThe next set of questions relate to quality of life, and how irritable bowel syndrome may have impacted on your symptoms. Thank you to researchers at Queens University in Canada for allowing us to use the IBS-36 QoL Questionnaire to evaluate participant quality of life in The FODMAP Challenge 1. In the past 2 months have you been afraid to eat out because of food causing bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.2. In the past 2 months have you felt angry as a result of your bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.3. In the past 2 months did you need to go suddenly when you had a bowel movement? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.4. In the past two months did your bowel symptoms interfere with your relationship/children/partner 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.5. In the past 2 months did you avoid foods that you like because you were afraid that they might cause bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.6. In the past two months did your bowel symptoms interfere with being able to do well at work/school/usual daily activities? 0 never, 6 always Leave blank if not applicablePlease enter a number from 0 to 6.7. In the past 2 months have you felt tearful or discouraged as a result of you bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.8. In the past 2 months did you feel that your family/friends thought your symptoms were not real? (0 never, 6 always) Leave blank if not applicable.Please enter a number from 0 to 6.9. In the past 2 months how often, while participating in pleasure or sport activities did you have to stop because of your bowel symptoms? 0 never, 6 always. Leave blank if not applicablePlease enter a number from 0 to 6.10. In the past 2 months have you felt worried or anxious about never feeling better? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.11. In the past 2 months did you miss work/school/usual daily activities because of your bowel problem? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.12. In the past 2 months did your bowel symptoms interfere with being able to concentrate? 0 never, 6 always. Leave blank if not applicable.13. In the past 2 months have you felt alone or isolated from your family because of bowel symptoms? 0 never, 6 always Leave blank if not applicablePlease enter a number from 0 to 6.14. In the past 2 months were you embarrassed because of your bowel symptoms? 0 never, 6 always Leave blank if not applicablePlease enter a number from 0 to 6.15. In the past 2 months were you troubled by pain in your abdomen? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.16. In the past 2 months were you afraid that your bowel symptoms were getting worse? 0 never, 6 always Leave blank if not applicablePlease enter a number from 0 to 6.17. In the past 2 months were you troubled y bowel movements that were difficult/hard to pass? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.18. In the past 2 months did you check your diet from the previous day trying to find foods that may cause bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.19. In the past 2 months did you avoid travelling due to worry about bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.20. In the past 2 months did your bowel problems shorten the length of time you could work each day? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.21. In the past 2 months did your bowel symptoms keep you from sleeping soundly during the night? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.22. In the past 2 months were you troubled by loose bowel movements? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.23. In the past 2 months did your bowel condition interfere with having sexual relations? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.24. In the past 2 months has being bloated troubled you? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.25. In the past 2 months did your bowel symptoms interfere with your enjoyment of leisure or sport activities? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.26. In the past 2 months was passing large amount of gas a problem? 0 never, 6 always Leave blank if not applicable.27. In the past 2 months were you concerned that your symptoms may be due to cancer? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.28. In the past 2 months have you had to delay or cancel going out socially because of your bowel problem? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.29. In the past 2 months were you tired in the morning because of your bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.30. In the past 2 months did your bowel symptoms interfere with your desire to have sexual relations with your partner? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.31. In the past 2 months has feeling that you need to go to the bathroom even though your bowels are empty troubled you? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.32. In the past 2 months did you feel that your doctor/health professionals did not believe that your bowel symptoms were real? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.33. In the past 2 months how often do you immediately need to find where the washrooms are when you are in a new place? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.34. In the past 2 months did you avoid planning activities ahead of time because you were unsure of how your bowel symptoms would be? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.35. In the past 2 months has accidental soiling of your underwear troubled you? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6.36. In the past 2 months were you late or did you delay work/school/usual daily activities because of your bowel symptoms? 0 never, 6 always Leave blank if not applicable.Please enter a number from 0 to 6. Part C - About your symptoms in The FODMAP Challenge, and the challenge itself1. How much of an improvement in your symptoms did you notice through following the low FODMAP diet?Please enter a number from 1 to 10.2. Over the course of a week, how many days did you stick to eating low FODMAP foods only?Please enter a number from 0 to 7.3. If you did not only eat low FODMAP foods, what was the main reason? Time for planning and preparation Taste Having to make more than one meal/meal prep for others Difficult when others are preparing meals Not noticing improvement in symptoms Other 4. Throughout the period of the food challenges, which groups did you notice a reaction to? Fructose (mango and honey) Lactose (milk and yoghurt) Onion fructan (onion) Garlic fructan (garlic) Mannitol (mushroom or avocado) Sorbitol (apricots or blackberries) Gluten (rye/barley) Wheat (bread/pasta) GOS (chickpeas, lentils, kidney beans) Did you determine a reaction to anything else? 5. Do you now feel confident that you know which types of FODMAPs are likely to tolerate well? Yes No Somewhat 6. Do you now feel confident that you know which types of FODMAPs you are likely to NOT tolerate well? Yes No Somewhat Part D - The Program1. Did you complete the 12 Week FODMAP Challenge (elimination and each challenge)?YesNoa. What was the main reason you did not follow through and finish the program? (Too long/Wasn’t seeing improvement/Too difficult/Other…..) 2.Please rate your overall experience during The FODMAP Challenge (10 being highest, 1 lowest)Please enter a number from 1 to 10.3. How useful did you find the meal plans?Please enter a number from 1 to 10.4. Which meal plan did you find more useful? Simple meal plan Standard meal plan 5. How often did you use the meal plans? Daily 1-2 days per week 3-4 days per week 5-6 days per week 6. How often did you stick to the recipe in the meal plans? Daily 1-2 days per week 3-4 days per week 5-6 days per week 7. How often did you modify the recipes for your own tastes? Daily 1-2 days per week 3-4 days per week 5-6 days per week 8. How useful did you find the facebook group for having questions answered? First Choice Second Choice Third Choice 9. Did you find the level of interaction in the Facebook group to be: Enough Not frequent enough Too frequent 10. If there was more interaction on the Facebook group, what would you like to see? 11. Did you find the resource section of the website easy to navigate? Yes No 12. Did you enjoy the weekly videos? Yes No 13. Was there anything we could have done to further assist you throughout the course of the program, to make life easier?14. Was there anything you particularly liked about the program? 15. Was there anything you particularly did not like about the program? 16. Do you have any suggestions for how we could improve the program?17. How likely would you be to recommend the program to someone? Very likely Likely Unlikely Very unlikely 18. Do you have any other comments?
