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Leaky Gut Syndrome Questionnaire

Check the number that most closely fits, then add up the results.

0= Symptom not present or rarely present

1= Mild /Sometimes

2= Moderate/Often

3= Severe/Almost always

Constipation and/or diarrhea
Joint pain or swelling, arthritis
Food allergies, sensitivities or intolerance
Chronic or frequent inflammations
Confusion, poor memory or mood swings
Asthma, hayfever, or airborne allegies
Mucous or blood in stool