Gallstones Screening Questionnaire
This questionnaire is intended for preliminary screening only and cannot replace a medical diagnosis by a physician.
1
Gender and Age Factors: Do you meet the “4F” risk criteria for gallstones? (Female, over 40, overweight, and previously pregnant)
2
Are you over 40 years old?
3
Weight and Metabolic Factors: Are you overweight or obese?
4
Do you have diabetes or high blood lipid levels?
5
Diet and Weight Change: Do you regularly consume a high-fat diet?
6
Have you experienced rapid weight loss or intermittent fasting?
7
Hormonal and Medication Factors: Have you had multiple pregnancies or are you currently pregnant?
8
Do you use oral contraceptives or long-term estrogen therapy?
9
Medical and Family History: Is there a family history of gallstones?
10
Have you ever been diagnosed with gallstones?
Your responses are anonymous and will be kept confidential.
This questionnaire does not collect personally identifiable information. By clicking to submit your responses, you agree to the terms of use.