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.

Personal Daily Diary

The full print version can be ordered here. Or print this page to use as your guide.

Using The Diary

The objective of using this Daily Diary is to gain a better understanding of your bowel disorder. Use this Personal Daily Diary for 2–4 weeks to help you get the most out of your next doctor visit.

By 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.

Name: ____________________ 
Day of the Week
: ____________  Date: ____________

Bowel Symptoms

Evacuation in Toilet

TimeStool Description & Symptom
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Gas

TimeDetails
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Stain/Smear

TimeStool Description & Symptom
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Incontinent Bowel Movement

TimeStool 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

TimeDescription & Duration
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Emotional Status

TimeDetails
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Medications

TimePrescription/Over-the-Counter
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Diet

Medications

TimePrescription/Over-the-Counter
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Foods

BreakfastTimeItems
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
Lunch Time Items
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
Dinner Time Items
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________
  ____________ ____________________________________

Beverages

TimeItems
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Exercise

TimeExercise Type
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________
____________ ____________________________________

Women

Menstrual cycle; ovulation; menstruation
____________________________________
____________________________________

Examples

DescriptionsExamples
Stool 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

Join the conversation

join conversation

Keep up-to-date on the latest news, stories, tips, research highlights, and more!

Sign up for eNewsletter

Connect through Facebook

Follow us on twitter