This assessment is for your personal use only.
It may help you to see a relationship between your emotional life and your physical suffering.

Download   printed IBS Self Assessment     

A Self Assessment Personal Questionnaire Which You Can Download

  • Marital Status

  • Age

  • Dependents

  • IBS related symptoms

  • How often do these occur?

  • How do they affect your daily life?

  • How do they effect the daily life of your family?

  • How does your family react?

  • Chronic diseases in your family of origin?

  • Age at first onset of IBS

  • Circumstances surrounding the last / current episode?

  • Have you visited your physician regarding your symptoms ?
     Yes___   No___

  • What has been the outcome of these visits?

  • What suggestions have you put into practice?

  • Which have you felt to be the most useful to you.?

  • How many times have you seen a physician regarding these symptoms in the past year?

  • If you have followed your doctors advice, on a scale of 1-5 how helpful have these visits been?

  • Education

  • Occupation

  • Main stresses on the job

  • Current family circumstances.

  •     Spousal




  • To whom have you traditionally felt closest?

  • Can you describe that relationship

  • What is the current status that relationship?

  • What other close relationships have you enjoyed?

  • What is their current status?

  • Describe a particular emotional stressor, be it an event or a thought which preceded a recent episode of IBS symptoms?

  • Has a similar situation preceded a past onset of the illness?
      Yes___   No___

  • Think of a period of time when you were symptom free? How was that time different from the time surrounding some current episodes?

  • Could the onset and the prior social/emotional conditions be related to your symptoms ? If so how?

If you have chosen to answer the questions, consider your responses. Do they indicate that incidents in your emotional life somehow determine or come before the episodes of the illness.

If that is the case, then you may want to consider a treatment for the emotional condition, which may impact your physical discomfort. Let me say this again, if your emotions have the power to disturb your physical equilibrium, then to quell the disturbance in your gut you may want to try to understand and gain some control over your emotions.

If you've seen your physician a number of times in the past year and it hasn't helped, you may want to find someone who has had training in psychotherapy, psychiatry or psychoanalysis and speak with them. Your city may have a psychoanalytic institute or a psychotherapeutic training program and they will have a list of therapists who will understand and perhaps help you to ameliorate your suffering.

You've tried many other remedies you may want to try this.


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