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Questionnaire on Pediatric GI Symptoms: Rome III Parent

169 Shared Subjects

Questionnaire on Pediatric Gastrointestinal Symptoms, Rome III Version (QPGS-RIII) - Parent Report adapted from Walker, Caplan-Dover and Rasquin-Weber (2000) as defined by Dr. Phillip Gorrindo at Vanderbilt University
Clinical Assessments
Questionnaire
07/12/2010
qpgs_iii_parent01
06/04/2020
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
Query qpgs_a1 String 200 Recommended In the last 2 months, how often did your child have pain or an uncomfortable feeling in the upper abdomen above the belly button? Never;1 to 3 times a month;Once a week;Several times a week;Every day
Query qpgs_a2_a String 200 Recommended Which of the following feelings did your child have above the belly button? PAIN
No;Yes
Query qpgs_a2_b String 200 Recommended Which of the following feelings did your child have above the belly button? NAUSEA
No;Yes
Query qpgs_a2_c String 200 Recommended Which of the following feelings did your child have above the belly button? BLOATING
No;Yes
Query qpgs_a2_d String 200 Recommended Which of the following feelings did your child have above the belly button? FEELING OF FULLNESS
No;Yes
Query qpgs_a2_e String 200 Recommended Which of the following feelings did your child have above the belly button? NOT BEING HUNGRY AFTER EATING VERY LITTLE
No;Yes
Query qpgs_a3 String 200 Recommended In the last 2 months, how much did your child hurt or feel uncomfortable above the belly button? I don't know;A little;Some (between a little and a lot);A lot;A very lot
Query qpgs_a4 String 200 Recommended When your child hurt or felt uncomfortable above the belly button, for how long did it last? Less than an hour;1-2 hours;3-4 hours;Most of the day;All the time
Query qpgs_a5 String 200 Recommended For how long has your child had pain or an uncomfortable feeling above the belly button? 1 month or less;2 months;3 months;4-11 months;1 year or longer
Query qpgs_a6 String 200 Recommended Did the hurt or uncomfortable feeling get better after your child had a poop? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a7 String 200 Recommended Were your child's poops softer and more mushy or watery than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a8 String 200 Recommended Were your child's poops harder or lumpier than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a9 String 200 Recommended Did your child have more poops than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a10 String 200 Recommended Did your child have fewer poops than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a11 String 200 Recommended Did your child feel bloated in the belly? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a12 String 200 Recommended Did your child have a headache? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a13 String 200 Recommended Did your child have difficulty sleeping? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a14 String 200 Recommended Did your child have pain in the arms, legs, or back? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a15 String 200 Recommended Did your child feel faint or dizzy? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_a16 String 200 Recommended Did your child miss school or stop activities? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b1 String 200 Recommended In the last 2 months, how often did your child have a belly ache or pain in the area around or below the belly button? Never;1 to 3 times a month;Once a week;Several times a week;Every day
Query qpgs_b2 String 200 Recommended In the last 2 months, how much did your child usually hurt in the area around or below the belly button? I don't know;A little;Some (between a little and a lot);A lot;A very lot
Query qpgs_b3 String 200 Recommended When your child hurt or felt uncomfortable around or below the belly button, for how long did it last? Less than an hour;1-2 hours;3-4 hours;Most of the day;All the time
Query qpgs_b4 String 200 Recommended For how long has your child had belly aches or pain around or below the belly button? 1 month or less;2 months;3 months;4-11 months;1 year or longer
Query qpgs_b5 String 200 Recommended Did it get better after having a poop? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b6 String 200 Recommended Were your child's poops softer and more mushy or watery than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b7 String 200 Recommended Were your child's poops harder or lumpier than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b8 String 200 Recommended Did your child have more poops than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b9 String 200 Recommended Did your child have fewer poops than usual? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b10 String 200 Recommended Did your child feel bloated in the belly? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b11 String 200 Recommended Did your child have a headache? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b12 String 200 Recommended Did your child have difficulty sleeping? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b13 String 200 Recommended Did your child have pain in the arms, legs, or back? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b14 String 200 Recommended Did your child feel faint or dizzy? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b15 String 200 Recommended Did your child miss school or stop activities? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_b16 String 200 Recommended In the last year, how many times did your child have an episode of severe intense pain around the belly button that lasted two hours or longer and made your child stop everything that he or she was doing? Never;1 time;2 times;3-5 times;6 or more times
Query qpgs_b16a_a String 200 Recommended During the episode of severe intense pain, did your child have any of the following? NO APPETITE
No;Yes
Query qpgs_b16a_b String 200 Recommended During the episode of severe intense pain, did your child have any of the following? FEELING SICK TO STOMACH
No;Yes
Query qpgs_b16a_c String 200 Recommended During the episode of severe intense pain, did your child have any of the following? VOMITING
No;Yes
Query qpgs_b16a_d String 200 Recommended During the episode of severe intense pain, did your child have any of the following? PALE SKIN
No;Yes
Query qpgs_b16a_e String 200 Recommended During the episode of severe intense pain, did your child have any of the following? HEADACHE
No;Yes
Query qpgs_b16a_f String 200 Recommended During the episode of severe intense pain, did your child have any of the following? EYES SENSITIVE TO LIGHT
No;Yes
Query qpgs_b16b String 200 Recommended Between episodes of severe intense pain, does your child return to his or her usual health for several weeks or longer?
No;Yes
Query qpgs_c1 String 50 Recommended In the last 2 months, how often did your child usually have poops?
2 times a week or less often;3-6 times a week;Once a day;2-3 times a day; More than 3 times a day; I don't know
Query qpgs_c2 String 50 Recommended In the last 2 months, what was your child's poop usually like?
Very hard;Hard;Not too hard and not too soft;Very soft or mushy;Watery;It depends (his/her poops are not always the same);I don't know
Query qpgs_c2a String 50 Recommended If your child's poops were usually hard, for how long have they been hard?
Less than 1 month;1 month;2 months;3 or more months; I don't know
Query qpgs_c3 String 200 Recommended In the last 2 months, did it hurt when your child had a poop?
No;Yes;I don't know
Query qpgs_c4 String 200 Recommended Did your child have to rush to the bathroom to poop? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_c5 String 200 Recommended Did your child have to strain (push hard) to make a poop come out? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_c6 String 200 Recommended Did your child pass mucus or phlegm (white, yellowish, stringy, or slimy material) during a poop? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_c7 String 200 Recommended Did your child have a feeling of not being finished after a poop (like there was more that wouldn't come out)? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_c8 String 200 Recommended In the last 2 months, did your child have a poop that was so big that it clogged the toilet?
No;Yes
Query qpgs_c9 String 200 Recommended Some children hold in their poop even when there is a toilet available. They may do this by stiffening their bodies or crossing their legs. In the last 2 months, while at home, how often did your child try to hold in a poop? Never;1 to 3 times a month;Once a week;Several times a week;Every day
Query qpgs_c10 String 200 Recommended Did a doctor or nurse ever examine your child and say that your child had a huge poop inside?
No;Yes
Query qpgs_c11 String 200 Recommended In the last 2 months, how often was your child's underwear stained or soiled with poop? Never;Less than once a month;1 to 3 times a month;Once a week;Several times a week;Every day
Query qpgs_c11a String 200 Recommended When your child stained or soiled underwear, how much was it stained or soiled? Underwear was stained (no poop);Small amount of poop in underwear (less than a whole poop);Large amount of poop in underwear (a whole poop)
Query qpgs_c11b String 200 Recommended For how long has your child stained or soiled underwear? 1 month or less;2 months;3 months;4-11 months;1 year or longer
Query qpgs_d1 String 200 Recommended Burp (belch) again and again without wanting to? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_d2 String 200 Recommended Pass a lot of gas very frequently? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_d3 String 200 Recommended Develop a clearly swollen belly during the day (you could see it was swollen)? Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_d4 String 200 Recommended Swallow or gulp extra air? (You might hear a clicking noise when your child swallows) Never;Once in a while;Sometimes;Most of the time;Always;I don't know
Query qpgs_d5 String 200 Recommended IN THE PAST YEAR, how many times did your child vomit (throw up) again and again without stopping for two hours or longer? Never;Once;2 times;3 times;4 or more times
Query qpgs_d5a String 200 Recommended For how long has your child had episodes of vomiting again and again without stopping? 1 month or less;2 months;3 months;4-11 months;1 year or longer
Query qpgs_d5b String 200 Recommended Did your child usually feel nausea when he or she vomited again and again without stopping?
No;Yes
Query qpgs_d5c String 200 Recommended Was your child in good health for several weeks or longer between the episodes of vomiting again and again?
No;Yes
Query qpgs_d6 String 200 Recommended In the past 2 months, how often did food come back up into your child's mouth after eating? Never;1 to 3 times a month;Once a week;Several times a week;Every day
Query qpgs_d6a String 200 Recommended Does this usually happen less than an hour after your child eats?
No;Yes
Query qpgs_d6b String 200 Recommended Does this happen while your child is sleeping?
No;Yes
Query qpgs_d6c String 200 Recommended Does your child usually feel nausea and vomit when this happens?
No;Yes
Query qpgs_d6d String 200 Recommended Does it usually hurt your child when the food comes back up into his or her mouth?
No;Yes
Query qpgs_d6e String 200 Recommended What does your child usually do with the food that comes back up into his or her mouth? Swallow it;Spit it out
Query visit String 60 Recommended Visit name
rome3_q_23 Integer Recommended Did this pain or burning usually get better or stop after a bowel movement (pain or burning in the middle of your abdomen, above your belly button but not in your chest)? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rcm3famulcrcolitscrohndisind Integer Recommended Do you have a parent, brother, or sister who has (or had) one or more of the following conditions: ulcerative colitis or Crohn's disease 0;1 0 = No; 1 = Yes
rcm3pnbuildupstdysevrelvlfreq Integer Recommended Did this pain build up to a steady, severe level? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3fdstck6mnthlngind Integer Recommended Have you had this problem 6 months or longer? 0;1 0 = No; 1 = Yes
rcm3anspnoccrdispprsamdayind Integer Recommended Did the pain in your anus and rectum occur and then completely disappear during the same day? 0;1 0 = No; 1 = Yes
rcm3famceliacdisind Integer Recommended Do you have a parent, brother, or sister who has (or had) one or more of the following conditions: Celiac disease 0;1 0 = No; 1 = Yes
rome3_q_24 Integer Recommended When this pain or burning started (pain or burning in the middle of your abdomen, above your belly button but not in your chest), did you usually have a change in the number of bowel movements (either more or fewer)? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_25 Integer Recommended When this pain or burning started (pain or burning in the middle of your abdomen, above your belly button but not in your chest), did you usually have softer or harder stools? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_26 Integer Recommended In the last 3 months, how often did you have bothersome nausea? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_27 Integer Recommended Did this nausea start more than 6 months ago (bothersome nausea)? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_28 Integer Recommended In the last 3 months, how often did you vomit? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_29 Integer Recommended Have you had this vomiting 6 months or longer? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_30 Integer Recommended Did you make yourself vomit? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_31 Integer Recommended Did you have vomiting in the last year that occurred in separate episodes of a few days and then stopped? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_32 Integer Recommended Did you have at least three episodes of vomiting (lasting a few days and then stopping) during the past year? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_33 Integer Recommended In the last 3 months, how often did food come back up into your mouth? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_34 Integer Recommended Have you had this problem (food coming back up into your mouth) 6 months or longer? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_35 Integer Recommended When food came back up into your mouth, did it usually stay in your mouth for a while before you swallowed it or spat it out? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_36 Integer Recommended Did you have retching (heaving) before food came into your mouth? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_37 Integer Recommended When food came into your mouth, how often did you vomit or feel sick to your stomach? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_38 Integer Recommended Did food stop coming back up into your mouth when it turned sour or acidic? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_39 Integer Recommended In the last 3 months, how often did you experience bothersome belching? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_40 Integer Recommended Did this bothersome belching start more than 6 months ago? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_41 Integer Recommended In the last 3 months, how often did you have discomfort or pain anywhere in your abdomen? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_42 Integer Recommended Did you have pain only (not discomfort or a mixture of discomfort and pain) in your abdomen (last 3 months)? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
version_form String 121 Recommended Form used/assessment name
rome3_q_43 Integer Recommended For women: Did this abdominal discomfort or abdominal pain (last 3 months) occur only during your menstrual bleeding and not at other times? 0::2; 999 0=No; 1=Yes; 2=Does not apply because I have had the change in life (menopause) or I am male; 999=Missing
rome3_q_44 Integer Recommended When you had this abdominal pain (in the last 3 months), how often did it limit or restrict your daily activities (for example, work, household activities, and social events)? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_45 Integer Recommended Have you had this abdominal discomfort or pain 6 months or longer? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_46 Integer Recommended How often did this abdominal discomfort or pain get better or stop after you had a bowel movement? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_47 Integer Recommended When this abdominal discomfort or pain started, did you have more frequent bowel movements? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_48 Integer Recommended When this abdominal discomfort or pain started, did you have less frequent bowel movements? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_49 Integer Recommended When this abdominal discomfort or pain started, were your stools (bowel movements) looser? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_50 Integer Recommended When this abdominal discomfort or pain started, how often did you have harder stools? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_51 Integer Recommended How often was this abdominal pain or discomfort relieved by moving or changing positions? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_52 Integer Recommended In the last 3 months, how often did you have fewer than three bowel movements (0-2) a week? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_17 Integer Recommended In the last 3 months, how often did you have pain or burning in the middle of your abdomen, above your belly button but not in your chest? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_53 Integer Recommended In the last 3 months, how often did you have hard or lumpy stools? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_54 Integer Recommended In the last 3 months, how often did you strain during bowel movements? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_55 Integer Recommended In the last 3 months, how often did you have a feeling of incomplete emptying after bowel movements? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_56 Integer Recommended In the last 3 months, how often did you have a sensation that the stool could not be passed, (i.e., was blocked), when having a bowel movement? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_57 Integer Recommended In the last 3 months, how often did you press on or around your bottom or remove stool in order to complete a bowel movement? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_58 Integer Recommended In the last 3 months, how often did you have difficulty relaxing or letting go to allow the stool to come out during a bowel movement? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_59 Integer Recommended Did any of the symptoms of constipation above begin more than 6 months ago? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_60 Integer Recommended In the last 3 months, how often did you have 4 or more bowel movements a day? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_61 Integer Recommended In the last 3 months, how often did you have loose, mushy, or watery stools? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_62 Integer Recommended In the last 3 months, were at least three-fourths (3/4) of your stools loose, mushy, or watery? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_18 Integer Recommended Have you had this pain or burning 6 months or longer (pain or burning in the middle of your abdomen, above your belly button but not in your chest)? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_63 Integer Recommended Did you begin having frequent loose, mushy, or watery stools more than 6 months ago? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rome3_q_64 Integer Recommended In the last 3 months, how often did you have to rush to the toilet to have a bowel movement? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_65 Integer Recommended In the last 3 months, how often was there mucus or slime in your bowel movement? 0::4; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rome3_q_66 Integer Recommended In the last 3 months, how often did you have bloating or distension? 0::6; 999 0=Never; 1=Less than one day a month; 2=One day a month; 3=Two to three days a month; 4=One day a week; 5=More than one day a week; 6=Every day; 999=Missing
rome3_q_67 Integer Recommended Did your symptoms of bloating or distension begin more than 6 months ago? 0;1; 88; 999 0=No; 1=Yes; 88=Not applicable; 999=Missing
rcm3pngoawycompltbtwnepisdfreq Integer Recommended Did this pain go away completely between episodes? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3uncmfrtblfullregszmealfreq Integer Recommended In the last 3 months, how often did you feel uncomfortably full after a regular-sized meal? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3achpnprssrans6mnthlngind Integer Recommended Did the aching, pain, or pressure in the anal canal or rectum begin more than 6 months ago? 0;1 0 = No; 1 = Yes
rcm3pnbrngnbwlmvmntflatltefreq Integer Recommended Did this pain or burning usually get better or stop after a bowel movement or passing gas? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3hrtbrn6mnthlngind Integer Recommended Have you had this heartburn (burning pain or discomfort in the chest) 6 months or longer? 0;1 0 = No; 1 = Yes
rome3_q_19 Integer Recommended Did this pain or burning (in the middle of your abdomen, above your belly button but not in your chest) occur and then completely disappear during the same day? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rcm3pnstpactvtyseedrerfreq Integer Recommended Did this pain stop your from your usual activities, or cause you to see a doctor urgently or to the emergency department? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3uncmfrtblfull6mnthlngind Integer Recommended Have you had this uncomfortable fullness after meals 6 months or longer? 0;1 0 = No; 1 = Yes
rcm3dcmfrtpndrmnstrlbldonlyind Integer Recommended Did this discomfort or pain occur only during your menstrual bleeding and not at other times? 0::2 0 = No; 1 = Yes; 2 = Does not apply because I have had the change in life (menopause) or I am male
rcm3bldstoolfreq Integer Recommended In the last 3 months, how often have you noticed blood in your stools? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3prstntwrsehoarsnssvcefreq Integer Recommended In the past 3 months, how often did you have persistent or worsening hoarseness of the voice? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3gallblddrremovlind Integer Recommended Have you had your gall bladder removed? 0;1 0 = No; 1 = Yes
rcm3unblfinshregszmealfreq Integer Recommended In the last 3 months, how often were you unable to finish a regular-sized meal? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3blckstoolfreq Integer Recommended In the last 3 months, how often have you noticed black stools? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3prstntwrsenckthrtpnfreq Integer Recommended In the past 3 months, how often did you have persistent or worsening neck or throat pain? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3gallblddrremovpnfreq Integer Recommended How often have you had this pain since your gall bladder was removed? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rome3_q_20 Integer Recommended Usually, how severe was the pain or burning in the middle of your abdomen, above your belly button? 1::5; 88; 999 1=Very mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very severe; 88=Not applicable; 999=Missing
rcm3unblfinshregszmeal6mnthind Integer Recommended Have you had this inability to finish regular-sized meals 6 months or longer? 0;1 0 = No; 1 = Yes
rcm3vomitbldfreq Integer Recommended In the last 3 months, how often have you vomited blood? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3mucsslimbwlmvmntfreq Integer Recommended In the last 3 months, how often was there mucus or clime in your bowel movement? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3chstpnexrtnhrtprblmfreq Integer Recommended In the past 3 months, how often did you have chest pain on exertion, or chest pain related to heart problems? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3heavfoodmouthfreq Integer Recommended Did you have retching (heaving) before food came into your mouth? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3accdntlkliqdsolidstoolfreq Integer Recommended In the last 3 months, how often have you accidentally leaked liquid or solid stool? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3anmcdrdiagnsind Integer Recommended Have you been told by your doctor that you are anemic (a low blood count or low iron)? (If female, not due to your menstrual period) 0;1 0 = No; 1 = Yes
rcm3nobwlmvmntsensnfreq Integer Recommended In the last 3 months, how often did you have a sensation that the stool could not be passed (i.e., was blocked), when having a bowel movement? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3diffswallwfreq Integer Recommended In the last 3 months, how often have you had difficulty swallowing? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3lkagerng Integer Recommended In the last 3 months, when this leakage occurred, about what amount was leaked? 1::3 1 = A small amount (staining only); 2 = Moderate amount (more than staining, but less than a full bowel movement); 3 = Large amount (a full bowel movement)
rome3_q_21 Integer Recommended Was this pain or burning affected by eating (pain or burning in the middle of your abdomen, above your belly button but not in your chest)? 0::2; 88; 999 0=Not affected by eating; 1=Worse pain after eating; 2=Less pain after eating; 88=Not applicable; 999=Missing
rcm3pndiscmfrtfreqbwlmvmntfreq Integer Recommended When this discomfort or pain started, did you have more frequent bowel movement? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm99degrtempdiffdayfreq Integer Recommended In the last 3 months, how often have you taken your temperature and found it to be over 99 degrees Fahrenheit (38 degrees Centigrade) on different days? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3lkagecompstntyp Integer Recommended In the last year, when this leakage occurred, what was the composition of leakage? 1::3 1 = Liquid/mucus only; 2 = Stool only; 3 = Both liquid/mucus and stool
rcm3untntnallst10lbsind Integer Recommended In the last 3 months, have you unintentionally lost over 10 pounds (4.5 kilograms)? 0;1 0 = No; 1 = Yes
rcm3stdypnmidrghtsdupabdmnfreq Integer Recommended In the last 6 months, how often did you have steady pain in the middle or right side of your upper abdomen? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3lumpfullthrtstckfreq Integer Recommended In the last 3 months, how often did you have a feeling of a lump, fullness, or something stuck in your throat? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3achpnprssransnobwlmvmntfrq Integer Recommended In the last 3 months, how often have you had aching, pain, or pressure in the anus or rectum when you were not having a bowel movement? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3feel6mnthlngind Integer Recommended Have you had this feeling 6 months or longer? 0;1 0 = No; 1 = Yes
rcm3rcntmjrbwlmvmntchng50yrind Integer Recommended If you are over age 50, have you had a recent major change in bowel movements (change in frequency or consistency)? 0;1 0 = No; 1 = Yes
rcm3feeloccrbetwnmealind Integer Recommended Does this feeling occur between meals (when you are not eating)? 0;1 0 = No; 1 = Yes
rome3_q_22 Integer Recommended Was this pain or burning relieved by taking antacids (pain or burning in the middle of your abdomen, above your belly button but not in your chest)? 0::4; 88; 999 0=Never or rarely; 1=Sometimes; 2=Often; 3=Most of the time; 4=Always; 88=Not applicable; 999=Missing
rcm3qstn68pnlst30minlngfreq Integer Recommended Did this pain last 30 minutes or longer? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3fddrnkstckslwfreq Integer Recommended In the last 3 months, how often did food or drinks get stuck after swallowing or go down slowly through your chest? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3eatdrnkswllwhrtfreq Integer Recommended When you are eating or drinking, does it hurt to swallow? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3achpnprssrdur Integer Recommended How long did the aching, pain, or pressure last? 1;2 1 = From seconds to up to 20 minutes and disappeared completely; 2 = More than 20 minutes and up to several days or longer
rcm3pndiscmfrtmidchstfreq Integer Recommended In the last 3 months, how often did you have pain or discomfort in the middle of your chest (not related to heart problems)? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
rcm3chstpn6mnthlngind Integer Recommended Have you had this chest pain 6 months or longer? 0;1 0 = No; 1 = Yes
rcm3famesphgsstmchcoloncncrind Integer Recommended Do you have a parent, brother, or sister who has (or had) one or more of the following conditions: cancer of the esophagus, stomach, or colon 0;1 0 = No; 1 = Yes
rcm3chstpnbrnfeelfreq Integer Recommended When you had your chest pain, how often did it feel like burning? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3fdstckassciatehrtbrnind Integer Recommended Was the symptom of food sticking associated with heartburn? 0::4 0 = Never or rarely; 1 = Sometimes; 2 = Often; 3 = Most of the time; 4 = Always
rcm3hrtbrnfreq Integer Recommended In the last 3 months, how often did you have heartburn (a burning discomfort or burning pain in your chest)? 0::6 0 = Never; 1 = Less than one day a month; 2 = One day a month; 3 = Two or three days a month; 4 = One day a week; 5 = More than one day a week; 6 = Every day
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

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