QUIZ: Are you Gut Bacteria Happy?

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- QUIZ: Are you Gut Bacteria Happy?

Home
Therapies
Get to Know Shanti
Products
- Product
Resources & Research
Contact
- Eligibility Pre-Screen Form
- QUIZ: Are you Gut Bacteria Happy?

Are you gut bacteria happy?

These questions can help you understand which experiences in your life, from birth until today, may have had an impact on the health of your gut bacteria/microbiome.

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Select One *

Do you have any of these digestive symptoms? Tick all that apply *

Diarrhoea/loose bowel movements Constipation Alternating diarrhoea and constipation Abdominal cramping/pain Bloating Wind/Flatulence Burping Acid Reflux Diagnosed with IBS

Have you done extensive overseas travel and been very unwell while overseas? *

YES NO Maybe

Have you had many vaccinations? *

Yes No Maybe

Have you had your tonsils removed? *

Yes No Don't know

Have you had chemotherapy or radiation treatment? *

Yes No

Have you ever needed steroid medications for more than one week, including steroid nasal sprays, or breathing inhalers, or topical creams? *

Yes No

Did you take antibiotics at least once every 2 to 3 years, or have you ever taken many courses in a short period of time (including herbal anti-microbial for SIBO)? *

Yes No Don't know

Did you suffer from frequent ear and/or throat infections as a child? *

Yes No Don't know

Did you require ear tubes/grommets as a child? *

Yes No Don't know

Have you had any recent surgeries, hospitalizations, or traumas, especially to the abdomen? *

Yes No Maybe

Please explain: *

Have you been on the contraceptive pill for more than 1 year? *

Yes No N/A

Do you take or have you taken any acid-blocking drugs (such as PPI) for more than 1 month (for acid reflux etc.)? *

Yes No Maybe

Do you take NSAIDs like ibuprofen or neurofen a regular basis? *

Yes No

Are you gluten-sensitive? *

Yes No Maybe

Is your diet high in grains? *

Yes No

Is your diet high in processed food? *

Yes No

Is your diet high in sugar? *

Yes No

Is your diet low in fibre and colourful fruits and vegetables? *

Yes No Maybe

Do you suffer from any allergies? *

Yes No Maybe

If yes, please explain *

Did your mother take antibiotics while she was pregnant with you? *

Yes No Maybe Don't know

Did your mother take steroids like prednisone while she was pregnant with you? *

Yes No Maybe Don't know

Does your mother have poor gut health? *

Yes No Don't know

Were you born by C-section? *

Yes No Don't know

Were you breast-fed for less than one month? *

Yes No Don't know

Are you a shift worker or are you sleep deprived/suffer from insomnia? *

Yes No

Do you suffer from Brain fog? *

Yes No Maybe

Do you have any Thyroid issues? *

Yes No Maybe

If yes, please explain .... *

Do you have a tendency to over-eat? *

Yes No Maybe

Are you dairy intolerant? *

Yes No Maybe

Do you have any other food allergies/intolerances? *

Yes No

form-required

If yes, please explain *

Are you extra sensitive to chemicals often found in everyday products and goods? *

Yes No Maybe

If yes, please explain *

Have you been diagnosed with an auto-immune disease (like Hashimoto's or Crohn's)? *

Yes No Maybe

Are you more than 10 kilos overweight? *

Yes No

Do you suffer from anxiety or depression? *

Yes No Maybe

Do you have any of the following digestive imbalances/diseases?

Choose any that apply *

Irritable Bowel Crohn's Disease Coeliac Disease Candida Diverticulitis Ulcerative Colitis Prolapse Fissures/Fistulas Hemorrhoids (severe) Cancer of the colon or rectum GastroIntestinal Hemorrhage GastroIntestinal perforation Abdominal hernia Inguinal hernia Cirrhosis Recent colon or rectum surgery Recent Abdominal surgery Advanced Ileitis

Please give details here: *

Do you have any food addictions or cravings? *

Yes No Maybe

If yes, please explain...which foods or flavours? *

Do you have any questions for me? *

What are your gut health goals? *

The more you answer 'yes', the higher your risk might be of gut dysbiosis....having a 'sick' or imbalanced microbiome. This could greatly be impacting on your overall health. Don't be alarmed if you find yourself answering 'yes' to a lot of these questions...You are not alone! The good news is, there's a LOT you can do about it, and best of all I am here to help coach you and you can do this work from home. It can be a relatively simple fix.
Here are 4 SIMPLE things you can do NOW to help improve your microbiome....1) CHEW 2) Find ways to reduce stress in your life 3) Eat more fermented foods 4) Have a tsp of apple cider vinegar with each meal.
This is just the beginning...I can help teach you what you need to know about how to improve your gut health, revive your microbiome, and create thriving lifelong health.
"All disease begins in the Gut" -- Hippocrates

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