pISSN 2636-0004eISSN 2636-0012
pISSN 2636-0004Gastric Cardinal Symptom Index
| Symptom | None | Very mild | Mild | Moderate | Severe | Very severe |
|---|---|---|---|---|---|---|
| 1. Nausea (feeling sick to your stomach as if you were going vomit or throw up) | 0 | 1 | 2 | 3 | 4 | 5 |
| 2. Retching (heaving as if to vomit, but nothing comes up) | 0 | 1 | 2 | 3 | 4 | 5 |
| 3. Vomiting | 0 | 1 | 2 | 3 | 4 | 5 |
| 4. Stomach fullness | 0 | 1 | 2 | 3 | 4 | 5 |
| 5. Not able to finish a normal-sized meal | 0 | 1 | 2 | 3 | 4 | 5 |
| 6. Feeling excessively full after meals | 0 | 1 | 2 | 3 | 4 | 5 |
| 7. Loss of appetite | 0 | 1 | 2 | 3 | 4 | 5 |
| 8. Bloating (feeling like you need to loosen your clothes) | 0 | 1 | 2 | 3 | 4 | 5 |
| 9. Stomach or belly visibly larger | 0 | 1 | 2 | 3 | 4 | 5 |
Data from the article of Revicki et al (
This questionnaire asks you about the severity of symptoms you may have related to your gastrointestinal problem. There are no right or wrong answers. Please answer each question as accurately as possible.
For each symptom, please circle the number that best describes how severe the symptom has been during the past 2 weeks. If you have not experienced this symptom, circle 0. If the symptom has been very mild, circle 1. If the symptom has been mild, circle 2. If it has been moderate, circle 3. If it has been severe, circle 4. If it has been very severe, circle 5. Please be sure to answer every question.