Association of upper gastrointestinal symptoms with functional and clinical characteristics in the elderly

Table 1 Upper gastroIntestinal symptom questionnaire for the elderly

UGISQUE		Symptoms in the last week	Questions	Response scale1
				0	1	2	3
Abdominal pain syndrome	1	Stomach ache or pain	Has he had pain or discomfort in the upper abdomen or the stomach?
	2	Hunger pains in stomach or belly	Has he had hunger pains? (an empty, hollow feeling in the stomach and the need to eat between meals)
Reflux syndrome	3	Heartburn	Has he suffered from heartburn? (a nagging, burning sensation in the upper chest or retrosternal region)
	4	Acid reflux	Has he had acid regurgitation? (a sudden regurgitation of stomach acid content to the esophagus)
Indigestion syndrome	5	Nausea	Has he suffered from nausea? (a feeling of discomfort in the stomach that can lead to vomiting)
	6	Rumbling in the stomach	Has he had rumbling stomach? (i.e. growling, bubbling or gurgling sounds)
	7	Bloated stomach	Has he suffered from bloating? (i.e. a fullness feeling correlated to gas build-up)
	8	Burping	Has he suffered from burping? (i.e. bringing up excessive air followed by a sense of relief)
Bleeding	9	Hematemesis	Has he had hematemesis? (vomiting blood) or melena (black stools)
	10	Melena
	11	Anemia	Loss of at least 3 g/dL of hemoglobin in the last 3 mo
Non-specific symptoms	12	Anorexia	Has he suffered from anorexia? (a loss of appetite or interest in food)
	13	Weight loss	Has he had a weight loss? (involuntary weight loss in the last 3 mo)
	14	Vomiting	Has he suffered from vomiting? (involuntary, forceful expulsion of gastric content through the mouth)
	15	Dysphagia	Has he had dysphagia? (sensation of difficulty in passing the food bolus through the esophagus)

¹Response scale: (0) absent = no symptoms are reported by patient; (1) mild = awareness of symptoms, but they are easily tolerated; (2) moderate = symptoms interfering with the normal activities; (3) severe = symptoms that induced inability to perform normal activities or symptoms requiring medical attention. UGISQUE: Upper gastroIntestinal symptom questionnaire for the elderly.