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GERD = Gastroesophageal Reflux Disease

GerdQ Assessment

Q1

Q2

Q3

Q4

Q5

Q6

1/6

Think about the past seven days

How often did you have a burning feeling behind your breastbone (heartburn)?

Breastbone image

2/6

How often did you have stomach contents (liquid or food) moving upwards to your throat or mouth (regurgitation)?

3/6

How often did you have a pain in the centre of the upper stomach?

4/6

How often did you have nausea?

5/6

How often did you have difficulty getting a good night’s sleep because of your heartburn and/or regurgitation?

6/6

How often did you take additional medication for your heartburn and/or regurgitation, other than what the physician told you to take? (such as Tums, Rolaid, Maalox)

iHow to identify GERDThis information is not a replacement for proper medical consultation. GerdQ assessment should be performed under the supervision of a doctor/pharmacist.