Please complete this form for 7 days. DID YOU STRAIN A DID YOU HAVE DAY/DATE TIME HARD SOFT WATERY TIME SPENT ON LOT? PAIN/DISCOMFORT? BSS 1 -2 3 - 4 5 - 6 7 THE TOILET YES/NO YES/NO Example: Monday 7th 3pm √ 20 mins no no
Please complete this form for 7 days. DAY/DATE TIME HARD BSS 1 -2 3 - 4 SOFT 5 - 6 WATERY 7 TIME SPENT ON THE TOILET DID YOU STRAIN A LOT? YES/NO DID YOU HAVE PAIN/DISCOMFORT? YES/NO Example: Monday 7th 3pm √ 20 mins no no
Bowel%20Habit%20Diary.docx