IBS food diary template: columns that make it useful

Why a diary and why these columns

The NHS lists a diary of what you eat and any symptoms among the things that can help once IBS has been diagnosed, so you can try to avoid your triggers. For diagnosis, it says a GP will ask what symptoms you have, how often, when you get them, for example after eating certain foods, and for how long, and that writing down details before the appointment may help you remember.

Those questions are the columns: when, what, which symptom, how long and how often. The extra columns, strength, bowel type and context, are our suggestion. They let a reader tell a bad day from a mild one, and a food reaction from a stressful week.

A worked example day

This is an invented example day to show the level of detail, not data from a real person.

• Mon 7:30. 2 slices wheat toast, 1 cup coffee with milk. Slept 5 hours, deadline at work.
• Mon 11:30. Bloating, 6 out of 10, started about 4 hours after breakfast.
• Mon 12:10. Bowel movement, Bristol type 6.
• Mon 13:00. Chicken salad, 1 apple, water. No symptoms by 16:00, noted as a good stretch.
• Mon 19:30. Pasta with garlic and onion sauce, 1 large bowl, 1 glass wine. Cramping at 21:00, 4 out of 10, gone by 23:00.
• Weekly look: bloating followed breakfast on 3 of 5 weekdays, all on short-sleep days. Wheat is only one of the possible links.

How the Bristol scale fits in

The Bristol stool form scale rates stool on seven types, from 1 to 7. In a 1997 study of 66 volunteers, stool form on that scale tracked whole-gut transit time better than stool frequency or output did, and the authors concluded that such scales can monitor change in intestinal function. That is why one number per bowel movement is worth the few seconds.

Note the type and the time, not a long description. A week of type 6 and 7 entries tells a clinician more than a paragraph about it.

Mistakes that make a diary useless

These are our own observations, not findings from a study. Entries made at night from memory lose the timing, which is what links a symptom to a meal. Portion words like “a bit” or “some” hide the amount, so write a cup, a slice or a number of grams.

Leaving out good days removes the comparison, and logging only suspected foods builds the answer into the data. Changing three things in the same week also muddies the picture. NICE advises that single food avoidance and exclusion diets, such as the low FODMAP diet, should be given only by a healthcare professional with expertise in dietary management, so a diary is the starting point for that conversation, not a replacement for it.

What your doctor or dietitian looks at

Bring the diary to the appointment with a one-line summary, such as how many weeks it covers, the worst days and the foods that appeared before them. The NIDDK notes that you may need to change what you eat for several weeks to see if symptoms improve, and that your doctor may recommend a dietitian, so a diary of a few weeks gives them something to work from.

See a GP if you think you have IBS and have had symptoms for over 4 weeks, or if diet changes and pharmacy medicines are not helping, or if you need to avoid lots of different foods to control symptoms. The NHS says to get an urgent appointment or help from NHS 111 for a lot of unexplained weight loss, bleeding from the bottom or bloody diarrhoea, a hard lump or swelling in the tummy, or shortness of breath with palpitations and paler skin. Our advice for US readers: call your doctor the same day for these signs, and call 911 if you feel seriously unwell.