Reflux Severity Index (RSI)
How to complete this Questionnaire:
- These are statements many people have used to describe throat sensations and other symptoms that may indicate reflu.
- In the last 1 month, how did the following problems affect you?
- Circle the rating number that reflects the severity of the problem for you, for each statement.
0 - 5 Rating Scale
0 = No problem
1 = Very mild problem
2 = Moderate or slight problem
3 = Moderate problem
4 = Severe problem
5 = Problem as bad as it can be