Your Condition | IBD Relief

What form of IBD have you been diagnosed with? Please be specific if you can.

Crohn's Disease Crohn's - Gastroduodenal (Upper) Crohn's - Jejunoileitis Crohn's - Ileitis Crohn's - Ileocolitis Crohn's - Colitis Crohn's - Perianal Ulcerative Colitis Ulcerative Colitis - Left-sided Ulcerative Colitis - Pancolitis Ulcerative Colitis - Proctosigmoiditis Ulcerative Colitis - Proctitis Indeterminate Colitis Lymphocytic Colitis Collagenous Colitis Undiagnosed I don't know

When did you first experience IBD symptoms?

When were you diagnosed with IBD?

If you've had surgery for your IBD, what procedures have you had? Choose all that apply

None Strictureplasty Resection Colectomy Proctocolectomy Ileostomy Restorative Proctocolectomy (J-Pouch) Fistulectomy Removal of Polyps

What medication are you currently taking? Choose all that apply

What symptoms are you currently experiencing? Choose all that apply

Diet Survey

1 Your Condition

2 Your Diet & Lifestyle

3 Meat, Poultry, Fish & Eggs

4 Milk & Dairy

5 Grains, Beans & Legumes

6 Vegetables

7 Fruit

8 Nuts, Sugars & Other Foods

9 Drinks

10 Complete

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