|
Duration of Constipation
• • •
|
Location Comments
|
|
Description
• • •
|
Quality Comments
|
|
frequency
• • •
|
Severity Comments
|
|
rectal bleeding
|
rectal bleeding description
• • •
|
|
abdominal pain
|
Onset Comments
|
|
weight loss
|
Exacerbating Comments
|
|
Severity
|
Relieving Symptoms Comments
|
|
Onset / Timing
• • •
|
|
|
Exacerbating factors
• • •
|
|
|
Relieving symptoms
• • •
|
|
|
previous treatments no help
• • •
|
|
|
|
|
|
|
|
|
New Field
|
|
|
New Field
|
|
|
New Field
|
|
|
New Field
|
|
