Sushrut E-OPD · Free Assessment

Patient Symptom Assessment

Please fill accurately. Your information is confidential and used only to prepare your personalised care plan.
કૃપા કરીને સાચી માહિતી ભરો · कृपया सही जानकारी भरें

Basic · Proctology · Gut Science · Ayurveda
Dr. Sushrut Patel | Dr. Ekta Patel

Step 1 of 40%

Part 0 — Basic Details

મૂળભૂત વિગતો · मूल विवरण

Gender / લિંગ / लिंग *
Preferred language for your report *

Part 1 — Proctology

મળદ્વારનું સ્વાસ્થ્ય · गुदा स्वास्थ्य

🚨 Red-flag safety check (Q7–Q10). Any YES triggers priority doctor review — kit is not auto-recommended until cleared.
Are you currently pregnant? *
Heavy bleeding from the anus — soaking a pad/cloth, or toilet water turning red? *
Fever along with pain near the anus? *
Pus or discharge from a wound/opening near the anus? (possible fistula) *
How long have you had these symptoms? *
Main complaints (select all that apply) *
If there is bleeding, how does it look? *
Pain level (0–10) *0 = no pain, 10 = worst
0 = no pain10 = worst
Do you sometimes pass stool or gas without control?
Have you taken any treatment before? *
Other health conditions (select all that apply)

Part 2 — Gut Science

પાચન અને મળત્યાગ · पाचन और मल त्याग

How often do you pass stool? *
What does your stool usually look like? (Bristol Stool Scale) *
Do you strain, or sit in the toilet for more than 10 minutes? *
Do you have gas, bloating or acidity?
How much water do you drink daily? *
How often do you eat fruit, vegetables, salad or whole grains? *

Part 3 — Ayurveda

અગ્નિ, આહાર, વિહાર, પ્રકૃતિ · अग्नि, आहार, विहार, प्रकृति

How is your appetite? (Agni) *
Which of these do you eat or take often? (Ahara) *
What time do you usually eat dinner? *
How is your sleep? (Nidra) *
How many hours do you sit in a day? (Vihara) *
Which best describes your body nature? (Prakriti)
✅

Report pending doctor review

Thank you! Dr. Patel's team will review your answers and send guidance on WhatsApp.
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