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Digestive Health Food Diary Use this diary to record what you eat & every day for 14 consecutive days

Supported by www.loveyourtummy.org Your 2-week food diary

Name

Date To

Food diary instructions:

1. List everything you eat and drink at each meal for every day

2. In the side section, tick all the relevant boxes

3. Take your completed diary with you when you visit your doctor or nurse to discuss if changes can be made to your diet and lifestyle that may help improve your digestive health

www.loveyourtummy.org Week 1

Day 1 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Mild

Breakfast Abdominal ache/pain Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium To Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 2 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 3 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 4 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 5 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 6 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 7 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Notes Week 2

Day 1 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 2 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 3 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 4 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 5 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Day 6 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong Day 7 Food eaten Symptoms Severity

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Breakfast Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Lunch Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Dinner Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Bloating Diarrhoea None

Flatulence/wind Constipation Mild

Snacks Abdominal ache/pain Heartburn Medium

Indigestion/dyspepsia Strong

Notes Notes How to use this food & symptom diary

A food diary is a great way of keeping a record of what you have had to eat and seeing if these foods have triggered any digestive symptoms. This can then lead to identifying ‘trigger’ foods in your diet

For each meal or snack write down:

• The food & the portion size e.g. breakfast: 2 weetabix biscuits with full fat milk and 1 teaspoon of sugar; 2 slices of brown bread with a scrape of low fat spread and jam

• Where you ate e.g. lunch eaten at work /home/shopping centre

• Any symptoms or feelings you had after the meal e.g felt bloated 1 hour after meal, constipated, diarrhoea, wanted to be sick

• Note any additional snacks you had e.g. chocolate, crisps, chips from take-away

• Remember to include food items such as gravies, sauces, dressing, ketchup, side-salads with meals

• For combination dishes e.g. stews, curries, pizza – try to record as much detail as possible about the ingredients that were used in the dish (jar of curry sauce with fried chicken, red peppers and onions)

For more information and tips on your digestive wellbeing, please visit www.loveyourtummy.org