If you want to kiss goodbye to abdominal pain, bloating, and bothersome bowels, you need to first understand what influences those pesky symptoms. Is it food? Stress levels? Maybe your period?
Since many factors play a role in the digestive distress common to irritable bowel syndrome, a bit of sleuthing is essential. A helpful tool for said sleuthing is the good ol’ food and symptom journal.
What is a food and symptom journal?
A food and symptom journal combines a symptom diary and a food journal in one handy record so you can spot connections between your food intake and your IBS symptoms. They can also be used to identify triggers for other medical conditions like Crohn’s disease, acid reflux, and food sensitivities.
Why keep a food and symptom journal?
Discover your symptom triggers
The ultimate goal of keeping a food and symptom journal is to determine which foods, beverages and lifestyle factors trigger IBS symptoms. Knowing what ties your guts in knots is the first step towards relieving your gastrointestinal woes.
Accuracy
The digestive system is a complex beast that is affected by many factors beyond just eating habits.
That’s why it’s easy to misidentify triggers and attribute symptoms to the wrong thing. If you mistakenly think dairy and gluten are your enemies when in fact stress is the true culprit, you end up on a severely restricted diet that limits your nutrition without treating your symptoms.
You need a more rigorous method for unearthing patterns, and a food and symptom journal is the most accurate way of doing so.
Memory
People are forgetful, plain and simple. By promptly recording symptoms, food, and other lifestyle factors, you’re more likely to record accurate data which will ensure a clearer understanding of your triggers.
Show your doctor or dietitian
Having clear notes about your digestive symptoms will help your doctor immensely in arriving at the correct diagnosis for you.
Similarly, with data on food and symptoms, your dietitian will be in a better position to help you identify your food triggers so you can come up with the most optimal diet plan for your body.
Determine the effectiveness of interventions
If you’re on the low FODMAP elimination diet, then keeping a detailed record of what you eat and how you feel is crucial.
First, accurate records will reveal whether you’ve had symptom improvement after cutting out moderate and high FODMAPs. Second, you’ll gain a clearer understanding of which FODMAPs you’re sensitive to so you can limit them for effective relief.
What should you record?
Food and symptoms of course. But also so much more….
Food and beverages
- Food and beverages you consume, especially food items known as gut irritants like spicy foods, fatty foods, coffee and alcohol.
- Water intake
- Brands of packaged food
- Portion sizes
- Time you eat and drink
Mood
- Emotions like anxiety, stress, anger, sadness
- Time when the emotion occurred. Perhaps it was all day, or perhaps you only felt the emotion for a specific time frame
Physical activity
- What activity
- Duration
- Intensity
Sleep
- How many hours you slept
- Quality of your sleep on a scale of 1-10
Menstrual cycle
- What phase are you in: menstruation, ovulation, follicular, or luteal
Medications, over-the-counter medications and supplements
Some gut-influencing examples include:
- Anti-anxiety or anti-depressant meds
- Antibiotics
- Pain medications
- Minerals and vitamins like iron or Magnesium
- Laxatives or anti-diarrheals
- Probiotics
- Fibre supplements
- Natural supplements like Iberogast
- Peppermint oil
- Enzymes
- Etc
Bowel habits
- Use the Bristol Stool Chart to help keep a detailed record of stool consistency
- Time, frequency and size of BMs
- Frequency of BMs
- Size of BMs
Symptoms
- What symptom (eg. bloating, pain, excessive flatulence, reflux, etc)
- How long did the symptom last
- Intensity of the symptom on a scale of 1-10
- Extra-intestinal symptoms like fatigue, headaches, back pain
Tips on how to best keep a food and symptom journal
- Record food and beverages right after eating or drinking
- Take pictures of your meals that you can log later in the day
- Record symptoms as they’re happening
- Keep your journal close at hand
- Put notifications in your phone to remind you to record
- Be consistent with recording
- At the end of each week, look back on your journal and see if you can spot any emerging patterns
Frequently asked questions
How long do I need to record for?
As long as you need to gain useful insight. Generally, recording for 2-4 weeks is a good idea.
If you’re on the low FODMAP diet, you should record your symptoms and bowel habits for at least 2 weeks before you start the elimination phase. You’ll need to record all the data listed above during the elimination phase to assess for diet effectiveness, and the reintroduction phase to determine your FODMAP triggers.
Don’t worry, you’re not keeping a journal forever!
What if I miss a day?
Progress over perfection. Be as consistent as you can, and aim to record for at least 5 days per week with at least one of those days being a weekend day since our weekend routines are often a bit different.
Can I use a phone app as my food and symptom journal?
Yes. Your Apple or Android app store has a variety of symptom trackers and food diaries for free or a fee. Here are a couple of my favs:
- Monash University’s low FODMAP diet app
- MySymptoms – this is a favourite of health professionals because you can send your clinician PDF exports of you data for professional analysis.
So if you’re finally ready to tame your IBS, download the free food and symptom journal above and start writing!
xoAndrea
