His Holiness
Maharishi
Mahesh Yogi
 
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Bowel incontinence

Your answers will enable us to develop your personalized consultation.
Select the consultation type for this disorder. For more information, click on the consultation type.
   Enhanced ($900)

   Additional or Follow-up ($450)
Issues
1) (required) Check one or more characteristics or information relevant to your current case of Bowel incontinence and its symptoms.
 Involuntary passage of stool  Sphincter injury
 Loss of sphincter control  Caused by central nervous system or spinal cord disorder
 Musculoskeletal impairment  Depression
 Severe anxiety  Aggravated by stress
 Gastrointestinal distress  Colostomy
 Stress incontinence precipitated by coughing, straining or heavy lifting  Poor nutrition
 Blocked energy flow  None
2) (required) Check one or more primary areas to be addressed.
  Anus
  Rectum
  Bowel
3) (required) Check one or more Sensations that are predominant in your case of Bowel incontinence.
  Shakiness   Itching   Numbness   Heaviness   Weakness   Rawness
  Pain   Stiffness, rigidity and/or tightness   Burning   Heat   None caused by Bowel incontinenceNone
4) Check one or more kinds of Pain that you experience in association with your case of Bowel incontinence or its symptoms.
  Sharp   Dull/Achey   Burning   Prickling   Stabbing   Shooting
  Unbearable   Constant   Occasional   Intermittent   Acute   Extreme
Current condition
5) (required) Select how often you experience Bowel incontinence or its symptoms.
Frequency of Bowel incontinence
6) (required) Currently, how severe is your case of Bowel incontinence or its associated symptoms?
Duration of Bowel incontinence     mild     moderate     severe     very severe
7) (required) How disabling is your case Bowel incontinence or its symptoms?
Disablity from Bowel incontinence  mildly  moderately  severely  very severely  Not at all
Disorder History
8) (required) Approximately, how long have you had Bowel incontinence or its symptoms?
Duration of Bowel incontinence  years  months  weeks
9) (required) Is your case of Bowel incontinence the result of an accident or another sudden traumatic event?
Bowel incontinence from accident yes  no  unsure
10) (required) Has your case of Bowel incontinence been medically diagnosed?
Bowel incontinence was medically diagnosed yes  no
11) Brief history of your case of Bowel incontinence and its treatment  (optional - up to 250 characters only) 
History of Bowel incontinence
12) How many prior 3-session Maharishi Vedic Vibration Technology consultations have you had for Bowel incontinence?
Prior MVVT treatments for Bowel incontinence  0  1  2  3  4 or more
12) What was the average percentage of relief you gained as a result?
Percent improvemnt through Bowel incontinence  75-100%  50-75%  25-50%  0-25%  Unsure
Comments
13) Additional comments (up to 250 characters only)
Comments about Bowel incontinence

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