• A symptom journal helps track patterns and identify triggers for your ulcerative colitis (UC) flares.
  • It often includes your symptoms, diet, activities, and medication.
  • A healthcare professional can use the journal to adjust your treatment.

Trying to manage an unpredictable health condition like UC can make your head spin. One day you feel perfectly fine, and the next you’re dealing with an uncomfortable bout of belly pain, diarrhea, and fatigue.

Your doctor might have told you that certain things set off your flares. But narrowing down those triggers can take some detective work. Did you eat too much ice cream? Or was it the stress from that botched work presentation that sent you running for the bathroom?

This is where a symptom journal can be a key part of managing UC. Writing down your symptoms on paper or using a smartphone app can help you start to see patterns linking your activities, diet, and symptoms. A symptom diary also makes it easier to share information with healthcare professionals.

Here’s a guide to help you start a symptom journal and what should go in it.

A symptom journal or tracker is a tool that helps you keep track of your inflammatory bowel disease (IBD) symptoms. You and your doctor can use it to link UC flares to what you were doing or eating at the time.

Your journal might include information about your:

  • symptoms, including when they started
  • diet
  • activities
  • medications for managing UC

You can also use the journal to track how UC affects your daily life. This may include your:

  • appetite
  • weight
  • emotions

Once you have a record of your symptoms and their effects, you can share it with your doctor at appointments.

The traditional way to keep a symptom journal is to write it by hand on paper or in a diary. More recently, smartphone apps like My IBD Care have made it easier to track your symptoms digitally and share them with your doctor.

Keeping a symptom journal will help you start to identify patterns and relationships between your diet, stress level, activities, and UC symptoms. For example, you might notice that your symptoms always flare up when you eat dairy products or when you’re upset.

A symptom journal can also help you and your doctor predict when the next flare might strike. If you’re starting to have more loose stools, for example, your doctor may change your medication or dose to avoid a full-blown flare.

Having a more complete picture of your symptoms also helps your doctor know whether your treatment is working. Choosing the right treatment for you can help slow disease progression and prevent complications. A symptom flare could be a sign that your medication has stopped working and you need a different medication or treatment.

It can be helpful to use a symptom journal every day, even when you’re not experiencing a flare. That way, you can start to look for patterns. Or you might use a journal only when your symptoms appear. Ask your doctor what they think would be most useful for you.

Keep a record of your symptoms between appointments. It’s easier to answer your doctor’s questions when you have a written list of your diet, activities, and symptoms right in front of you.

The more details you can give your doctor, the better. You can ask your doctor which information would be most helpful.

Here’s a list to get you started:

  1. Did you have symptoms today?
  2. What were your symptoms? Common UC symptoms include:
    • loose bowel movements
    • belly pain
    • rectal bleeding
    • fatigue
    • nausea
    • weight loss
  3. How many bowel movements did you have? What was their consistency (loose or firm)?
  4. How severe were your symptoms on a scale from 1 to 10?
  5. What did you eat? Common UC triggers include:
    • high fiber foods, like raw fruits and vegetables
    • non-absorbable sugars, found in fruit juices
    • sugary foods
    • dairy products
    • high fat foods
    • alcohol
    • caffeinated drinks
    • spicy foods
  6. How did UC symptoms affect other aspects of your life? Consider your:
    • eating habits
    • appetite
    • activity level
    • sleep
    • sex life
    • work
  7. How did UC affect your emotions? For example, symptoms may make you feel:
    • sad
    • lonely
    • frustrated
    • overwhelmed
    • embarrassed
  8. What other symptoms or health concerns have you had? These may include:
    • joint pain
    • skin conditions
    • liver concerns
    • eye complications
    • other issues (name them)
  9. What medications did you take? Include all prescription and over-the-counter medications. After you took the medication, note whether your symptoms:
    • got better
    • stayed the same
    • got worse

A symptom journal is an easy and convenient way to keep track of your UC flares. You can use it to figure out how your diet and daily activities affect your symptoms.

Share your journal with the doctor who treats your UC at each visit. Your doctor can use your notes as a guide to ask for more tests or adjust your treatment when needed.