About you | IBD Relief

What type of IBD do you have?

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

In what country do you receive your IBD care?

How old were you when you were diagnosed?

If you were diagnosed under the age of 16 years, did anyone previously talk to you or give you information about changing from paediatric services to adult services for your ongoing care?

Yes No

If yes, how did you receive this information?

If no, what information would have been helpful?

What medication are you currently taking? Choose all that apply

Have you had surgery for your IBD? Choose all that apply

Which of the following are most applicable to you? Choose all that apply

Have been pregnant since IBD diagnosis Trying for a pregnancy Considering pregnancy in future I do not want children Completed my family before being diagnosed with IBD

Fertility and pregnancy

1 About you

2 Fertility

3 Going through pregnancy

4 Trying/considering a pregnancy in future

5 Menopause

6 Accessing information in the future

7 Supporting our work

8 Complete

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