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Questionnaires - Leaky Gut

Although many of the symptoms associated with food intolerance are identical to those of leaky gut syndrome, the symptoms can be distinguished by looking at the typical causes and conditions. These are listed in the book, as well as the interpretation of your score and Action Plan. You can purchase the book 'The Food Intolerance Bible' on this website. You may also like to print out the questionnaire below for completion.

Have I Got Leaky Gut Syndrome?

Part 1 (1 point for each)

Do you (or have you recently) on a regular basis...

  1. Eaten foods to which you have an intolerance?
  2. Drunk alcohol on more than 4 nights a week?
  3. Taken antibiotics more than twice a year?
  4. Taken steroid medications (e.g. cortisone) for more than one week a year?
  5. Taken NSAIDs (aspirin, ibuprofen, etc.) for more than two weeks in a year?
  6. Eaten the same foods every day, with a total of less than 15 foods comprising the bulk of your diet in any given week?
  7. Eaten sugar every day?
  8. Had digestive problems such as wind, bloating, discomfort, pain, irregular bowels (diarrhoea / constipation), reflux, indigestion?
  9. Felt that you are anxious or stressed a lot of the time?
  10. Gone on extended fasts or starvation diets?
  11. Been on an IV drip for whatever reason?
  12. Undergone radiation therapy?
  13. Undergone surgery?
  14. Eaten lots of spicy food
  15. Were you born premature?

Total Part 1 Score -------------- / 15

Part 2 (4 point for each)

Do you suffer from ...

  1. Colitis or Crohn's disease?
  2. Acute gastroenteritis?
  3. Alcoholism?
  4. Ankylosing spondylitis?
  5. Alopecia areata?
  6. Arthritis?
  7. Asthma?
  8. Burn Injuries?
  9. Chronic fatigue syndrome (CFS)?
  10. Coeliac disease?
  11. Crohn's disease?
  12. Cystic fibrosis?
  13. Diabetes (type I)?
  14. Eczema?
  15. Endotoxaemia?
  16. Fibromyalgia?
  17. Lupus (SLE)?
  18. Multiple sclerosis?
  19. Pancreatic dysfunction?
  20. Polymyalgia rheumatica?
  21. Raynaud's disease?
  22. Rheumatoid arthritis?
  23. Schizophrenia?
  24. Sjogren's syndrome?
  25. Thyroiditis?
  26. Trauma?
  27. Ulcerative colitis?
  28. Urticaria (hives)?
  29. Vasculitis?
  30. Vitiligo?

Total Part 2 Score =

Grand Total =