Dose the patient being treated have any of the following conditions?

• If you have abdominal pain which suddenly changes in its location.

• Intestinal obstruction or perforation (a hole in the intestines).

• Gas that occurs regularly many times per month or gas that has persisted for several months.

• Gas or bloating that is severe or debilitates you.

• Gas or bloating that is happening more frequently over time.

• Gas that is accompanied by fatigue, diarrhea, constipation, weight loss, or other symptoms.


Yes

No






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