Your Guide to Tracking Crohn’s Symptoms

If you have Crohn’s disease, your gastroenterologist will likely want you to track your symptoms. Whether you use a smartphone app or old-fashioned pen and paper, the benefits of doing so are far-reaching, says Arun Swaminath, MD, director of the Inflammatory Bowel Diseases Program and chief of the division of gastroenterology at Lenox Hill Hospital in New York City.

Journaling can identify patterns that help match Crohn’s disease symptoms — diarrhea, rectal bleeding, cramps, weight loss, fever, flatulence — with triggers and exacerbating factors. It can also provide information on how well a treatment is working, among other things.

The more details you can provide your doctor about the onset, severity, and duration of your Crohn’s disease symptoms, the better they can determine the right treatment plan for you, says Jenny Sauk, MD, a gastroenterologist and associate clinical professor of medicine at the David Geffen School of Medicine at UCLA in Los Angeles.

Tracking symptoms of Crohn’s disease can also warn of an oncoming flare, Dr. Sauk says. For instance, if your doctor sees a trend in your symptoms, such as more episodes of liquid stools between visits, they may decide to perform a colonoscopy sooner than originally planned. Tweaking your Crohn’s disease treatment based on symptom tracking may help stave off a full-blown flare.

How to Track Crohn’s Disease Symptoms

You can use a smartphone app to track your Crohn’s symptoms, and the collected information can be readily shared with your doctor, says James Marion, MD, a professor of medicine at the Icahn School of Medicine and a gastroenterologist at Mount Sinai Hospital in New York City.

For example, the smartphone apps GI Buddy (free) and mySymptoms Food Diary & Symptom Tracker ($4.99) allow you to input information about diet, symptoms, and activities that can be sent to your doctor. “Symptom tracker apps are more efficient, because notes taken with paper and pen have to be transcribed and can’t be transmitted,” Dr. Marion says. The apps also organize your symptoms for you.

But tracking symptoms by writing them down can still work, Sauk says.

The Crohn’s & Colitis Foundation has a chart you can use to track symptoms without a smartphone. Sauk suggests starting a written journal with the following information about your Crohn’s disease symptoms:

• Date and time of symptom onset
• Type of symptom
• Intensity of the symptom (on a scale of 1 to 10)
• Detailed description of the symptom

It’s also helpful to note any steps you took to alleviate the symptom, she says.

Lastly, consider keeping the chart in the same place, such as in the bathroom, to remind yourself to document the most relevant symptoms.

Crohn’s Disease Symptoms: What to Track

No matter which method you choose, it’s important to track the following Crohn’s disease symptoms and triggers.

Diet There’s no one-size-fits-all diet that helps (or aggravates) Crohn’s disease symptoms. “Each person seems to have something different that sets symptoms off, but if it can be determined that a person has the same negative response with repeated exposure to fatty or spicy foods, for example, steps can be taken to eliminate the triggers,” Dr. Swaminath says.

Bowel movements The number and consistency of bowel movements are important to record, Marion says. “Your doctor needs to know if you get up to go the bathroom in the middle of the night, because that’s a sign that the bowel is significantly inflamed,” he says. This information can help guide treatment decisions.

Medication “When people feel well, they aren’t as good about taking their medications, so a journal could show that noncompliance caused a flare,” Swaminath says, although he points out that a flare might happen months later, as opposed to soon after missing or stopping the medication. Some medications, including over-the-counter pain relievers, may also set off a flare, and a journal can help make this connection, too, he says. It’s important to keep track of all the medications you take, including over-the-counter drugs and nutritional supplements.

Sleep, stress, and other factors Sleep patterns and stress levels should also be noted, Marion says. “If these triggers are identified, you and your doctor can work on managing your stress or improving your sleep,” he says. Women should also note when they have their period to see if it worsens or causes symptoms, he says.

Keeping track of symptoms and triggers can help you better manage your Crohn’s disease. This can provide your doctor with valuable information to help you achieve remission and improve your quality of life.