From: Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry
 | Never | Occasionally | Sometimes | Often | Always |
---|---|---|---|---|---|
1. Do you get heartburn? | 0 | 1 | 2 | 3 | 4 |
2. Does your stomach get bloated? | 0 | 1 | 2 | 3 | 4 |
3. Does your stomach ever feel heavy after meals? | 0 | 1 | 2 | 3 | 4 |
4. Do you sometimes subconsciously rub your chest with your hand? | 0 | 1 | 2 | 3 | 4 |
5. Do you ever feel sick? | 0 | 1 | 2 | 3 | 4 |
6. Do you get heartburn after meals? | 0 | 1 | 2 | 3 | 4 |
7. Do you have an unusual (eg burning) sensation in your throat? | 0 | 1 | 2 | 3 | 4 |
8. Do you feel full while eating meals? | 0 | 1 | 2 | 3 | 4 |
9. Do some things get stuck when you swallow? | 0 | 1 | 2 | 3 | 4 |
10. Do you get bitter liquid (acid) coming up into your throat? | 0 | 1 | 2 | 3 | 4 |
11. Do you burp a lot? | 0 | 1 | 2 | 3 | 4 |
12. Do you get heartburn if you bend over? | 0 | 1 | 2 | 3 | 4 |
Total Acid reflux symptoms (total = 48) | |||||
Total Dyspeptic (dysmotility) symptoms (total = 20) |