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How to keep a food and symptom diary
A food and symptom diary is a dated record of what you ate and how you felt afterwards. Kept properly it turns "it has been rough lately" into something a clinician can read.
The short answer
Write down each meal, each symptom, and each dose of medication, at the time it happens. Note the clock time for all three. Rate symptoms on the same scale every day.
If you can, keep it for two weeks before looking for patterns. That gives you more than one or two days to compare.
Take the record to your appointment. Do not use it to cut foods out on your own.
Why the timing matters more than the detail
Most people try to reconstruct the week the night before an appointment. It does not work. By then the meals have merged and the bad days have lost their order.
The useful part of a diary is the clock. A symptom at 9pm after a 7pm meal is a different fact from the same symptom on waking. You only have that if you wrote the time down.
So the record has to be quick enough to keep on the day you feel worst. A five minute daily write-up sounds reasonable and gets abandoned in a week. Ten seconds per entry does not.
What to record
The meal
What you ate, roughly how much, and how soft it was. Texture matters here more than in an ordinary food diary. Note the time you started eating.
The symptoms
Which symptom, how bad, and when it began. If it followed a particular meal, say which one.
Rate severity the same way every time. Any fixed scale works as long as you never change it. Gastroenterology clinics often measure these symptoms with a questionnaire called the Gastroparesis Cardinal Symptom Index, which covers fullness and early satiety, nausea and vomiting, and bloating. Wording your own notes along the same lines makes them easier for a specialist to read.
Medication
What you took and when. Some drugs used in gastroparesis are timed around meals. Recording a missed or late dose gives your clinician more context for that day.
Weight and fluids
Use the same scales at roughly the same time of day, under similar conditions. Track what you drink as well. Poor nutrition and dehydration are real risks with this condition, and a series of readings is more useful than one number.
How to read it back
Count, then think. Look for foods that appear often and are followed by symptoms often. One bad meal is too little to establish a pattern. If the same food is followed by symptoms four times out of six, write that count in your appointment notes.
Watch out for the obvious traps. You eat safe foods more often, so they collect more entries. You are more likely to log on bad days than good ones. Neither ruins the record, but both change how you should read it.
A diary shows what happened together. It does not show what caused what. That call belongs with your clinician, who can weigh it against your history, tests and treatment.
Do not remove food groups on your own because of what a diary seems to show. The ACG guideline notes that restrictive eating is common in people with gastroparesis, and says eating disorders have to be considered. Bring the suspect food and your notes to your clinician instead.
Taking it to an appointment
Appointments are short. A brief summary is easier to discuss than a stack of raw entries. Bring the summary and keep the detail behind it.
Useful things to have ready:
- How many days in the period had each main symptom.
- Your weight at the start and at the end.
- Which medications you took, and how often you missed a dose.
- The two or three foods you are least sure about, with counts.
- The questions you want answered, written down before you go in.
If you use paper, photocopy it. If you use an app, export the summary as a file you can hand over or email.
See a three-page sample GI report made by GastroLog from example entries. It shows symptoms, timing after meals, bowel movements, weight, medicines, questions and food patterns.
Paper or an app
Paper is free and works everywhere. It is also easy to lose, and adding up two weeks of it by hand the night before an appointment is miserable.
An app can time-stamp entries for you, repeat a meal you have logged before, and add up the counts. The thing to check before you pick one is how many taps a single entry takes. General calorie trackers ask for portions and macros you do not need, and they have nowhere to put nausea.
When to get help straight away
A diary is not a reason to wait. NIDDK says to seek a doctor's help right away if you have severe pain or cramping in your abdomen, blood glucose that is too high or too low, red blood in your vomit, vomit that looks like coffee grounds, sudden sharp stomach pain that does not go away, vomiting for more than an hour, extreme weakness or fainting, trouble breathing, or a fever.
Get help too for signs of dehydration or poor nutrition, such as extreme thirst, a dry mouth, dark urine, passing less urine than usual, unplanned weight loss, dizziness, and pale skin.
GastroLog keeps this record in a few taps
GastroLog is a food and symptom diary built for gastroparesis. Meals you have eaten before repeat in one tap. Symptoms are tappable buttons with a five point severity scale, so an entry needs no typing. A symptom can be tagged to the meal it followed, and the meal list reaches back through the night.
Your last two weeks line up on one screen. Every food builds its own count of how often symptoms followed. The app shows you the count and leaves the call to you and your clinician.
Everything stays on your phone. There is no account and no sign-up.
Free to log meals, symptoms, medication and reminders, with the past two weeks of trends. A one-time $4.99 unlocks the PDF export and the full trend history. No subscription. iPhone and Android.Sources
- Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J. Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Alimentary Pharmacology & Therapeutics. 2003;18(1):141–150. doi:10.1046/j.1365-2036.2003.01612.x
- Camilleri M, Kuo B, Nguyen L, Vaughn VM, Petrey J, Greer K, Yadlapati R, Abell TL. ACG Clinical Guideline: Gastroparesis. American Journal of Gastroenterology. 2022;117(8):1197–1220.
- Symptoms & Causes of Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases. Last reviewed January 2018.