IFFGD has developed a Personal Daily Diary that is intended to help you gain a better understanding of your bowel disorder. By keeping a detailed record of diet, medication, stool consistency, frequency, continence, pain, emotional status, and exercise, a clearer understanding may start to emerge for you and/or your physician to determine the best treatment options available to you.
Using The Symptom Diary
The objective of a Daily Diary is to help you better understand your gastrointestinal illness. Using a Personal Daily Symptom Diary for 2–4 weeks can help you learn more about how your body may be reacting to certain things in your life, such as diet, exercise, stress, and sleep.
When keeping a detailed record of stool consistency, frequency, continence, pain, diet, medication, emotional status and exercise, a clearer understanding may start to emerge for you and/or your physician to determine the best treatment options available to you.
Find examples of what to record at the bottom of this page.
Learn more about treatments for IBS
Download our IBS Personal Daily Diary to start tracking today
Name: ____________________ Day of the Week: ____________ Date: ____________
Bowel Symptoms
Evacuation in Toilet
| Time | Stool Description & Symptom |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Gas
| Time | Details |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Stain/Smear
| Time | Stool Description & Symptom |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Incontinent Bowel Movement
| Time | Stool Description & Symptom |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Bowel Symptoms Summary
| Number of daytime evacuations: ____________ |
| Number of nighttime evacuations: ____________ |
| Number of stains or smears: ____________ |
| Number of incontinent bowel movements, if any: ____________ |
| Number of protect undergarments used, if any: ____________ |
Pain
| Time | Description & Duration |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Emotional Status
| Time | Details |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Medications
| Time | Prescription/Over-the-Counter |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Diet
Medications
| Time | Prescription/Over-the-Counter |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Foods
| Breakfast | Time | Items |
|---|---|---|
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| Lunch | Time | Items |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| Dinner | Time | Items |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ | |
| ____________ | ____________________________________ |
Beverages
| Time | Items |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Exercise
| Time | Exercise Type |
|---|---|
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
| ____________ | ____________________________________ |
Women
| Menstrual cycle; ovulation; menstruation |
|---|
| ____________________________________ |
| ____________________________________ |
Examples
| Descriptions | Examples |
|---|---|
| Bowel Movement (Description) | Loose; diarrhea; formed; hard, pellet-like; ribbon-shaped |
| Symptoms | Incomplete evacuation; strong urge; straining; incontinent; stain/smear |
| Gas | Belching; flatus |
| Pain | Abdominal cramping; lower intestinal cramping; pain on either side of abdomen; tenderness (tender when touched); rectal pain (sharp dull, burning; feels like a hard object is in rectum; cramping sensation in rectum) |
| Emotional Status How do you feel? Why? |
Fine; happy; relaxed; anxious; nervous; sad; unhappy, depressed; fatigued; tired (wake up tired, wake up during the night) – mentally tired, physically tired |
| Stressors | Daily obligations; employment; school; family; social; travel; shopping; medical appointments; illness; injury; trauma; surgery; personal/intimate |
| Medications | Prescription/over-the-counter including herbs or supplements; and Dosage |
| Women | Menstrual cycle; ovulation; menstruation |
| Food List everything, be detailed. |
Fruits; vegetables; dairy products; meat; fish; poultry; breads (whole grain, etc); pasta; dessert; condiments (salt, pepper, sauces, spices, oils) |
| Beverages | Caffeine; decaffeinated; carbonated; diet/sugar free; alcohol; fruit juices |
| Exercise |
List examples: walk, run, bike, swim, aerobic, other; and times |
