Food and symptoms diary

An example of a food and symptoms diary

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Alison Cullen
Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
@AVogelUK
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Day 1: Food diary

 

Food

Symptom               

7am:

Banana on two slices of buttered wholemeal bread, one latte

 
  8.30am:

Gurgling of stomach and slight bloating

10am:

An apple

10am:

Stomach is still slightly bloated but no worse

12 noon:

A portion of fresh supermarket chicken soup, some mixed seed flatbreads and some cashews

 
  1pm:

More bloating and some embarrassing flatulence

3pm:

A cup of tea with milk and a chocolate biscuit

 
  4pm:

Painful stomach that dies down slightly after going to the toilet

7pm:

A portion of spaghetti bolognaise made with wholewheat pasta, beef meetballs sauteed in onion, a jar of tomato and basil sauce

 
  8pm:

Still feeling bloated but the pain isn't so bad

Day 1: What’s the verdict?

Ok, so something appears to be causing you an issue.

Symptoms appear early after breakfast, which consisted of a source of gluten (the bread) and lactose (in the coffee and butter) both are also sources of FODMAPs so it isn’t yet clear what’s going on.

As the day goes on, the apple doesn’t appear to worsen symptoms (a source of FODMAP so this could be worse if this was the problem but hard to measure).

Lunch again seems to cause a major problem but did you know this meal may contain hidden lactose (in the soup), gluten (in the flatbreads) and FODMAP-rich cashews, so which is causing the issue? You will need to keep a diary for several days to try to gain a better understanding.

Your afternoon snack seems to cause some upset but is back under control after an urgent trip to the toilet. Does this signal IBS may be present too?

Dinner doesn’t seem to cause too many problems and is rich in gluten and sources of FODMAP... this is too confusing we need to observe more patterns.

Day 2: Food diary

 

Food

Symptom               

7.30am:

Porridge made with semi-skimmed milk and peanut butter. Tea with milk

 
  9am:

My stomach is expanding as we speak and feeling very sensitive

10am:

A banana and espresso

10am:

Stomach is still slightly bloated but the noises have started to settle down

12.30pm:

A bagel with cream cheese, smoked salmon and rocket. A handful of strawberries and sparkling water.

 
  1pm:

Stomach pain followed by some loose stools. A patch of skin on my arm is looking red and a bit itchy.

3pm:

A mocha from local Costa

 
  4pm:

In agony for the remainder of the day, flatulence is happening, which makes me feel stressed, when I'm stressed I need the toilet more!

7pm:

Chicken caesar salad with croutons

 
  8.30pm:

Still quite bloated as I head of to bed but better than earlier in the day.

Day 2: What’s the verdict?

There are definitely some patterns forming.

Symptoms appear after breakfast again. Today the breakfast is likely to be gluten-free although we can’t rule this out as oats are often contaminated. Milk is present in fairly large amounts, which is both a source of lactose and considered a FODMAP.

The banana and espresso are FODMAP free and don’t seem to cause any major changes.

Lunch again seems to cause a flare up. It could be due to the gluten in the bagel or dairy content of the cream cheese.

The mocha from Costa doesn’t go down well: is it the large amount of dairy?

Dinner doesn’t seem to cause too many problems but there may be some hidden dairy lurking in that salad dressing...

Overall thoughts

Ok, so from the patterns that seem to be emerging it appears likely that dairy or lactose (hard to determine which specifically at this early stage) could be causing you an issue. We can’t rule out gluten or FOMDAPs though as symptoms after initial exposure can take a while to appear.

Toilet habits and response to stress and caffeine could suggest IBS in combination with an intolerance but best to visit your doctor to get further checks.

After a week or two of recording a food and symptoms diary you might want to try excluding dairy from your diet. Do this for several weeks to see if your symptoms improve. Slowly you can then reintroduce components, for example lactose free milk or low lactose cheese to see how you react.

If you can manage your intolerance your suspected IBS may also improve and more so if you limit caffeine intake and try to manage your stress levels.

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To relieve indigestion and flatulence. Also available in 50ml size. Fresh herb tincture.
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