Bowel diary

Why keep a bowel diary at all?

Because memory is a terrible instrument. When a GP or gastroenterologist asks how often you go, what it looks like, and whether anything makes it worse, most people guess. Guidelines from bodies such as the NHS and NIDDK consistently point to a written record as one of the most useful things a patient can bring to a first consultation: it turns a vague complaint into something a clinician can pattern-match.

A diary is especially useful when you are:

• investigating suspected food triggers, for example alongside an elimination or low-FODMAP trial run by a dietitian;
• tracking a change in bowel habit that has lasted more than a couple of weeks;
• monitoring a known condition such as IBS between appointments;
• checking whether a new medication, supplement or routine change is affecting your gut.

What to record

Keep it short enough that you will actually keep doing it. Four things carry most of the clinical value:

1. When. Date and time. Frequency and rhythm matter more than most people realise.
2. What it looked like. The Bristol stool scale, types 1 to 7. Types 3 and 4 are generally considered the ideal; 1 and 2 lean constipated, 6 and 7 lean loose.
3. How it felt. Straining, urgency, pain, bloating — and blood, always.
4. What might explain it. Meals, alcohol, caffeine, stress, medication. Triggers rarely act instantly, so the note you wrote yesterday often explains today.

When to stop self-tracking and see a doctor

A diary is a record, not a diagnosis. NHS and NIDDK guidance in general terms is to seek medical advice promptly if you notice blood in your stool, unexplained weight loss, persistent pain, a change in bowel habit that lasts beyond a few weeks, or diarrhoea that will not settle. Bring your export — that is exactly what it is for.

Prefer paper, or tracking for a child?