| Location of abdominal pain• • • | Location Comments | 
| Quality• • • | Quality Comments | 
| Severity | Severity Comments | 
| Duration• • • | Duration Comments | 
| Onset / Timing• • • | Onset Comments | 
| Exacerbating factors• • • | Exacerbating Comments | 
| Relieving symptoms• • • | Relieving Symptoms Comments | 
| Previous Treatment |  | 

