dg
[p.192]

Section S -- Digestive Disorders

Section S1 -- Specific Conditions

1. During the past 12 months, did you have gallstones?

1[] Yes (5)
2[] No
9[] DK

2. During the past 12 months, did you have any other gallbladder trouble?

1[] Yes (5)
2[] No
9[] DK

3. Have you ever had gallstones?

1[] Yes (5)
2[] No
9[] DK

4. Have you ever had any other gallbladder trouble?

1[] Yes
2[] No (8)
9[] DK (8)

5. When did a doctor first tell you that you had (gallstones/gallbladder trouble)?

1[] Less than 3 months ago
2[] 3 months, less than 1 year
3[] 1 year, less than 2 years
4[] 2 years, less than 5 years
5[] 5 years, less than 10 years
6[] 10 years or more
7[] Doctor never seen (8)
9[] DK when

6a. Have you ever had gallbladder surgery?

1[] Yes
2[] No (7)
9[] DK (7)

b. When did you last have gallbladder surgery?

1[] Less than 3 months ago
2[] 3 months, less than 1 year
3[] 1 year, less than 2 years
4[] 2 years, less than 5 years
5[] 5 years, less than 10 years
6[] 10 years or more
9[] DK when

7. Have you ever had any of the following tests to help diagnose your (gallstones/gallbladder condition) --

a. An X-ray of your gallbladder or abdomen?
Read if necessary: For this X-ray you would have been given either pills the night before or an intravenous injection just before the X-rays were taken.

1[] Yes
2[] No
9[] DK

b. A sonogram or ultrasound of your gallbladder?
Read if necessary: For this test, a gel is rubbed on your upper right side and an instrument is moved around the area while an examiner watches on a television screen.

1[] Yes
2[] No
9[] DK

c. An upper GI series?
Read if necessary: For an upper GI series, you drink a chalky white liquid called barium, and then X-rays are taken.

1[] Yes
2[] No
9[] DK

8. During the past 12 months, did you have an ulcer?

1[] Yes (10)
2[] No
9[] DK

9. Have you ever had an ulcer?

1[] Yes
2[] No (13)
9[] DK (13)

10. When did a doctor first tell you that you had an ulcer?

11. Did the doctor say you had a gastric, duodenal, or peptic ulcer, some other type, or were you not told?
Mark all that apply

0[] Skin (13)
1[] Gastric
2[] Duodenal
3[] Peptic
4[] Stomach
7[] Not told
8[] Other -- (Specify) ____
9[] DK

[p. 193]

Section S1 -- Specific Conditions -- Continued

12. Have you ever had any of the following tests to help diagnose your ulcer --

a. An upper GI series?
Read if necessary: For an upper GI series, you drink a chalky white liquid called barium, and then X-rays are taken.

1[] Yes
2[] No
9[] DK

b. An upper endoscopy or gastroscopy?
Read if necessary: For this test, a long flexible tube with a light on the end is inserted down the throat so that the lining of the stomach and the upper intestine can be examined

1[] Yes
2[] No
9[] DK

13. During the past 12 months, did you have diverticulitis?

1[] Yes (15)
2[] No
9[] DK

14. Have you ever had diverticulitis?

1[] Yes
2[] No (18)
9[] DK (18)

15. When did a doctor first tell you that you had diverticulitis?

16a. Have you ever been in the hospital overnight for diverticulitis?

1[] Yes
2[] No (17)
9[] DK (17)

b. When were you last in the hospital overnight for diverticulitis?

1[] Less than 3 months ago
2[] 3 months, less than 1 year
3[] 1 year, less than 2 years
4[] 2 years, less than 5 years
5[] 5 years, less than 10 years
6[] 10 years or more
9[] DK when

17. Have you ever had a barium enema to help diagnose your diverticulitis?
Read if necessary: For this X-ray, you would have been given an enema containing barium and X-rays of your abdomen would be taken.

1[] Yes
2[] No
9[] DK

18a. During the past 12 months, have you had a spastic colon, functional bowel, irritable colon or irritable bowel syndrome?

1[] Yes
2[] No (19)
9[] DK (19)

b. Which -- spastic colon, functional bowel, irritable colon, or irritable bowel syndrome?
Mark all reported, do not probe.

1[] Spastic colon (19c)
2[] Functional bowel (19c)
3[] Irritable colon (19c)
4[] Irritable bowel syndrome (19c)
8[] Other similar condition mentioned (Specify) ____ (19c)

19a. Have you ever had a spastic colon, functional bowel, irritable colon, or irritable bowel syndrome?

1[] Yes
2[] No (20)
9[] DK (20)

b. Which -- Spastic colon, functional bowel, irritable colon, or irritable bowel syndrome?

1[] Spastic colon
2[] Functional bowel
3[] Irritable colon
4[] Irritable bowel syndrome
8[] Other similar condition mentioned (Specify) ____

c. When did a doctor first tell you had (entry in 18b or 19b)?

20. Have you had hemorrhoids in the past 12 months?

1[] Yes (21b)
2[] No
9[] DK

21a. Has a doctor ever told you that you had hemorrhoids?

1[] Yes
2[] No (section S2)
9[] DK

b. When did you last talk to a doctor about your hemorrhoids?

22. Have you ever had surgery in a doctor's office, clinic, or hospital for hemorrhoids?

1[] Yes
2[] No
9[] DK

[p. 194]

Section S2 -- Abdominal Pain

Hand Card S1.

Card S1
Card S1 depicts the torso of a body. The abdomen is divided into sections 9 numbered sections. The right and left sides are labeled. Generally, the numbers correspond as follows:

1 upper right
2 upper midline
3 upper left
4 mid right
5 middle
6 mid left
7 lower right
8 lower midline
9 lower left

The next questions are about pain and discomfort in the abdomen. By abdominal, we mean (the shaded area on this diagram/the area between the lower ribs and the hips). Do not include pain related to kidneys, bladder, or arthritis (menstruation or pregnancy).
1. During the past 12 months, have you had any type of pain or severe discomfort in your abdomen three or more times?

1[] Yes
2[] No (Section S3)
9[] DK (Section S3)

2. Have you ever made a visit to a doctor for your abdominal pain?
If asked: or the condition that caused the pain.

1[] Yes
2[] No (4)
9[] DK (4)

3a. What condition did the doctor say was the cause of the pain?
Enter first 5 code numbers and the conditions in the order mentioned. Do not probe.

[option for 5 code and condition entries in the original document not presented here]

98[] Doctor didn't say (4)
99[] DK
Code ____
Condition ____

If only one response, in 3a, enter in 3b without asking.
b. Which of these conditions caused the most pain during the past 12 months?
Enter code number and condition.

Code ____ (Check item 1)
Condition ____ (Check item 1)
99[] DK (Check item 1)

4a. What condition do you think was the cause of the pain?
Enter first 5 code numbers and the conditions in the order mentioned. Do not probe.

[option for 5 code and condition entries in the original document not presented here]

99[] DK (5)
Code ____
Condition ____

If only one response to 4a, enter 4b without asking.
b. Which of these conditions caused the most pain during the past 12 months?
Enter code number and condition.

Code ____ (Check item 1)
Condition ____ (Check item 1)
99[] DK (Check item 1)

Assignment of Codes
1. Give highest priority to codes 01-04.
2. If a condition or word in a condition is asterisked, assign asterisked codes 55-62.
3. If a condition and part of body are reported, assign code for the part of body.

01 Spastic colon
02 Functional bowel
03 Irritable colon
04 Irritable bowel syndrome
05 Allergies
06 Anxiety
07 Appendicitis
08 Cancer
09 Cirrhosis
10 Colitis
11 Constipation
12 Crohn's disease
13 Depression
14 Diarrhea
15 Diverticulitis
16 Diverticulosis
17 Enteritis
18 Esophagitis
19 Flu
20 Food poisoning
21 Gallbladder problem
22 Gallstones
23 Gastritis
24 Gastroenteritis
25 Growth
26 Heartburn
27 Hepatitis
28 Hernia, other than hiatal
29 Hiatal hernia
30 Impacted bowels
31 Indigestion
32 Infection
33 Influenza
34 Lactose Intolerance
35 Medication side effects
36 Nerves
37 Obstructed bowels
38 Other bowel trouble
39 Other liver trouble
40 Other stomach trouble
41 Peritonitis
42 Stress
43 Tension
44 Trouble swallowing
45 Tumor
46 Ulcer
47 Ulcerative colitis
48 Virus
* 55 Arthritis
* 56 Back problems
* 57 Bladder
* 58 Kidneys
* 59 Menstruation
* 60 Other female trouble
* 61 Pregnancy
* 62 Prostate
63 Other -- Specify above
64 Other -- Specify above
65 Other -- Specify above
66 Other -- Specify above
67 Other -- Specify above
* Do not ask questions 5-27 about these conditions.

[p. 195]

Section S2 -- Abdominal Pain -- Continued

Ask questions 5-27 about the first condition coded 01-04 in 3a or 4a. If none, ask about condition in 3b or 4b. If this is an asterisked condition, ask about next condition mentioned in 3a or 4a. If this is "DK", begin with question 5, but do not read parentheticals. If no other condition, go to Section S3.

Check Item 1
Enter code and condition.

Code ____
Condition ____

(These next questions are about pain related to your (condition in Check item 1)).

Ask if "Yes" in 2; otherwise go to 8.
5. How many DIFFERENT doctors have you visited for this pain?

0[] None (8)
1[] One
2[] Two
3[] Three or more

6. During the past 12 months, how many doctor visits did you have because of this pain?

000[] None
001[] One
Number of visits ____

7. Were any of the following tests done (to diagnose your (condition in check item 1))?

a. Upper GI series?
Read if necessary: You drink a chalky white liquid called barium and then X-rays are taken.

1[] Yes
2[] No
9[] DK

b. Barium enema?
Read if necessary: You are given an enema containing barium and X-rays of your abdomen are taken.

1[] Yes
2[] No
9[] DK

c. Upper endoscopy or gastroscopy?
Read if necessary: A long flexible tube with a light on the end is inserted down the throat so that the lining of the stomach and the upper intestine can be examined.

1[] Yes
2[] No
9[] DK

d. Lower endoscopy or colonoscopy?
Read if necessary: A long flexible tube with a light on the end is inserted in the rectum so that the lining of the large intestine can be examined.

1[] Yes
2[] No
9[] DK

e. Sonogram or ultrasound?
Read if necessary: A gel is rubbed on your upper right side and an instrument is moved around the area while an examiner watches on a television screen.

1[] Yes
2[] No
9[] DK

Mark box or ask.

0[] Telephone interview (9)

Hand Card S1.

Card S1
Card S1 depicts the torso of a body. The abdomen is divided into sections 9 numbered sections. The right and left sides are labeled. Generally, the numbers correspond as follows:

1 upper right
2 upper midline
3 upper left
4 mid right
5 middle
6 mid left
7 lower right
8 lower midline
9 lower left

8. Looking at this card, tell me the numbers that show you where the pain (from the (condition in Check Item 1)) was located?
Mark all that apply.
Do not probe.

1[] (11)
2[] (11)
3[] (11)
4[] (11)
5[] (11)
6[] (11)
7[] (11)
8[] (11)
9[] (11)

9. Was the pain above the waistline, below the waist, or around the waistline?
Mark all that apply.

1[] Above
2[] Below
3[] Around

10. Was the pain on the right side, the left side, or down the middle?
Mark all that apply.

1[] Right
2[] Left
3[] Middle

11. When you get this pain, how long does it usually last?

____

1[] Minutes
2[] Hours
3[] Days

7777[] Constant, all the time
8888[] Varies too much for a usual duration

12. During how many days in the past year did you have this pain?

001[] One (15)
Days ____
365[] Everyday

If more than 14 days in 12, go to 14
13. Did all of this pain occur during one two week period?

1[] Yes (15)
2[] No

14. During how many different months in the past year did you have this pain?

Months ____

15. On a scale from 1 to 10, where 1 is mild and 10 is severe, how would you rate this pain at its worst?
Circle one

01[]
02[]
03[]
04[]
05[]
06[]
07[]
08[]
09[]
10[]

16. Have you ever taken any medication for the pain?

1[] Yes
2[] No (18)

17. Was any of the medication you took prescribed for you by a doctor?

1[] Yes
2[] No

18. When this pain starts, do you have to stop what you are doing because it hurts?

1[] Yes
2[] No

19. When you have this pain, do you usually have bowel movements?

1[] Yes
2[] No

20. When you have this pain, are your bowel movements usually looser than normal?

1[] Yes
2[] No

21. When you have this pain, are your bowel movements usually more frequent than normal?

1[] Yes
2[] No

22. Is the pain usually relieved or lessened by having a bowel movement?

1[] Yes
2[] No

23. Is the pain relieved by passing gas?

1[] Yes
2[] No

24. When you have this pain, is your abdomen usually swollen or bloated?

1[] Yes
2[] No

25. When you have this pain, are you ever awakened from sleep?

1[] Yes
2[] No

26. In the past 30 days, has the pain caused you to cut down on the things you usually do?

1[] Yes
2[] No (Section S3)

27. In the past 30 days, how many days did you cut down for more than half the day?

00[] None
Days ____

[p.196]

Section S3 -- Normative Bowel Functions

These next questions are about bowel habits during the past 12 months. (Because these questions are personal, I can read the questions to you or if you prefer, you can fill them out yourself.)

1. How often do you usually have bowel movements?

Times per day ____
Or
Times per week ____
00[] Less than one time per week

Hand Card Q1. Read answer categories if telephone interview.

Card Q1

1. Always
2. Most of the time
3. Some of the time
4. Rarely
5. Never

2. During the past 12 months, how often have your bowel movements been --

a. Hard?