Even the healthiest of eaters can suffer digestive related back pain. With dietary issues, we are looking for either a change in the chemical system or repetitive patterns that can also result in back pain. These questions will help you assess your digestive factors. Your score will automatically appear at the end of the survey. As always, we recommend you consult with your own doctors and/or medical professionals.

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* 1. Please provide the following information.

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* 2. Have you been constipated or had diarrhea recently?

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* 3. Has your stomach been bothering you?

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* 4. Have you had an increase in gas?

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* 5. Have you changed your vitamin regimen?

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* 6. Have you eaten spicy foods recently?

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* 7. Have you changed your diet?

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* 8. Have you drunk more than four alcoholic beverages in one sitting in the past week?

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* 9. Do you frequently consume protein bars or protein shakes?

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* 10. Have you been on any new medications?

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* 11. Do you tend to have the same meals more than three times in a week?

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* 12. Do you depend on coffee or soda to stay awake during the day?

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* 13. Have you increased your fiber intake?

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* 14. Do you eat five or more cups of fruits and vegetables in a day?

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* 15. Do you use an artificial sweetener?

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* 16. Have you recently become a vegetarian?

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