Mydyspepsia Survey | Overview  
Overview
Complete our survey to receive your knowledge, symptom and quality of life scores.

Eligibility

This survey is for those who experience the symptoms of dyspepsia and GERD, including:
  • Pain in the upper abdomen
  • Acid regurgitation
  • Heartburn
  • Increased burping and bloating
  • Nausea or vomiting
  • Feeling full too soon
Or have been diagnosed with any of the following conditions that may produce these types of symptoms:
  • Helicobacter pylori infection
  • Non-ulcer dyspepsia (functional dyspepsia)
  • Peptic ulcer disease
  • Gastroesophageal reflux disease (GERD)
  • Hiatal hernia
  • Gallstones
If you have been diagnosed with any of these conditions or you have experienced any of the symptoms listed above for at least three months, then this survey is appropriate for you.

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About the survey

The purpose of the mydyspepsia questionnaire is to examine the association between symptom severity, quality of life and familiarity with dyspepsia, GERD, and related conditions. One of the main goals of this survey is to compare those who come to see specialists to an "Internet population". Historically there have been significant differences between the two.

This survey should take about 10 minutes to complete and contains several sections:
  1. demographics,
  2. the Dyspepsia & GERD Knowledge Questionnaire (DGKQ),
  3. the SF-12 (a quality of life survey), and
  4. part of the Gastrointestinal Symptom Rating Scale (GSRS) to assess symptom severity.
Your responses will be scored immediately for you to review.

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Privacy Policy and Participation

If you choose to participate in the research component of the site, it is important that you know that only the site adjudicator and the principle investigator will have access to the information you submit. Unless you agree to it, no sponsors or other agencies will ever have access to your personal information and you will not be identifiable in any published reports.

I have read the sections above and understand that my responses will be used for research purposes only, and that I may withdraw from the study by emailing the site adjudicator.

Complete our survey to receive your knowledge, symptom and quality of life scores.