Exit this survey >>

1. GI Symptoms, Gluten and Weight Loss Surgery

Recently we have seen patients that have GI symptoms after weight loss surgery. Some may have symptoms related to "Gluten" insensitivity. We want to help and to learn more.

Please complete this survey for help in understanding more about GI symptoms, gluten and weight loss surgery

Question Title

* 1. Patient Information

Question Title

* 2. Birth Date

Question Title

* 3. What is your height in Feet and Inches? (example 5 Feet 4 inches)

Question Title

* 4. What is you weight today in pounds?

Question Title

* 5. Have you had Weight Loss Surgery?

Question Title

* 6. If you had weight loss surgery, What was your weight on the day of surgery?

Question Title

* 7. If you have had weight loss surgery, Date of Surgery

Date

Question Title

* 8. Year of Weight Loss Surgery (Double Checking your answer from above)
** Preliminary Results **
2007 15.6%
2008 6.7%
2009 26.7%
2010 37.8%

Question Title

* 9. PreOp Weight (Double Checking your answer from above)

Question Title

* 10. Weight You Lost from Surgery

Question Title

* 11. Overall how satisfied are you with your weight loss surgery?
** Initial Results: Extremely Satisfied 59%; Very Satisfied 36%; Somewhat Satisfied 4%

T