Dyspepsia Questionnaire
What a dyspepsia questionnaire asks, with sample questions on stomach symptoms, ulcers, pain medicines, and earlier tests.
A dyspepsia questionnaire records upper stomach symptoms, fullness and bloating, past ulcers, pain medicines, earlier tests, and smoking and alcohol use before a GI visit. Its questions come from the stomach and ulcer items on GI new patient and procedure forms.
Dyspepsia questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a dyspepsia questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample dyspepsia questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Do you have stomach or abdominal pain?Symptoms
- Do you have heartburn or nausea?Symptoms
- Do you get full quickly when eating?Eating
- Do you have bloating or belching?Eating
- Have you had a stomach or duodenal ulcer?Ulcer history
- Has a relative had peptic or stomach ulcers?Ulcer history
- Do you take aspirin, ibuprofen, or other NSAIDs?Medicines
- Which medicines do you take for pain?Medicines
- Have you had an upper endoscopy (EGD)?Past tests
- Have you had an abdominal ultrasound or CT scan?Past tests
- Do you smoke, or did you smoke before?Lifestyle
- How many alcoholic drinks do you have weekly?Lifestyle
These are examples to read, not a form to fill in.
Dyspepsia questionnaire: FAQ
What does a dyspepsia questionnaire ask?
The sample questions on this page are based on a GI practice's new patient questionnaire and University of Iowa Health Care and HealthPartners forms. This page groups them into six areas: symptoms, eating, ulcer history, medicines, past tests, and lifestyle.
Who fills in a dyspepsia questionnaire, and when?
The patient, before a GI visit about indigestion or upper stomach symptoms.
Does it ask about pain relievers?
Yes. The HealthPartners form lists aspirin and NSAIDs among the medicines it asks about, and it also asks about medicines for pain management.
Does it ask about ulcers in the family?
Yes. The gastroenterology practice's questionnaire asks which relatives have had peptic or stomach ulcers, along with other GI illnesses.
Does it ask about earlier tests?
Yes. A GI practice's new patient questionnaire asks for the dates of any upper endoscopy (EGD), abdominal sonogram, or CAT scan.
What happens after the dyspepsia questionnaire is completed?
The gastroenterologist reads the answers before the visit and decides whether any test is needed. AI Doctor collects the answers and does not interpret symptoms.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
