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Yes/No Questions
Please answer each question with Yes or No.
Do you ever see bright red blood on the toilet paper or in the toilet bowl after you go poop?
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Do you ever see bright red blood on the toilet paper or in the toilet bowl after you go poop? (required)
Yes
No
Do you feel a small, sore bump or swelling right around your bottom?
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Do you feel a small, sore bump or swelling right around your bottom? (required)
Yes
No
Does your bottom itch a lot, or feel like it is burning and irritated?
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Does your bottom itch a lot, or feel like it is burning and irritated? (required)
Yes
No
When you use the toilet, does it feel like a little piece of skin is popping out of your bottom?
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When you use the toilet, does it feel like a little piece of skin is popping out of your bottom? (required)
Yes
No
Does it hurt or feel really uncomfortable to sit in a hard chair or drive your car for a long time?
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Does it hurt or feel really uncomfortable to sit in a hard chair or drive your car for a long time? (required)
Yes
No
After you finish using the bathroom, do you still feel like you need to go more?
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After you finish using the bathroom, do you still feel like you need to go more? (required)
Yes
No
Do you find yourself pushing really hard to poop, or sitting on the toilet for a very long time?
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Do you find yourself pushing really hard to poop, or sitting on the toilet for a very long time? (required)
Yes
No
Is it hard to get totally clean when you wipe, or do you notice slimy stuff in your underwear?
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Is it hard to get totally clean when you wipe, or do you notice slimy stuff in your underwear? (required)
Yes
No
If you sit or stand all day for work, do you get a heavy, dull ache in your backside?
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If you sit or stand all day for work, do you get a heavy, dull ache in your backside? (required)
Yes
No
Did you suddenly get a hard, painful purple bump down there that makes it hard to move around?
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Did you suddenly get a hard, painful purple bump down there that makes it hard to move around? (required)
Yes
No
Do you often have hard poops that hurt to push out?
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Do you often have hard poops that hurt to push out? (required)
Yes
No
If you are pregnant, just had a baby, or lift heavy things a lot, do you feel a new pressure or bulge down below?
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If you are pregnant, just had a baby, or lift heavy things a lot, do you feel a new pressure or bulge down below? (required)
Yes
No
Do you catch yourself moving around in your seat a lot just trying to get comfortable?
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Do you catch yourself moving around in your seat a lot just trying to get comfortable? (required)
Yes
No
Have you started taking warm baths or using special wet wipes to calm down the burning and swelling?
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Have you started taking warm baths or using special wet wipes to calm down the burning and swelling? (required)
Yes
No
Does the pain of wiping or seeing a little blood make you scared to use the bathroom?
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Does the pain of wiping or seeing a little blood make you scared to use the bathroom? (required)
Yes
No
If you answered (YES) to more than 5 questions, you may need to try our spray to prevent hemorrhoids from growing.
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