Managing Crohn’s disease often involves several strategies to address symptoms like frequent diarrhea, fatigue, abdominal pain, and joint pain. Alongside medication, greater awareness of how lifestyle factors impact you is crucial. That often starts with food choices and whether they affect your symptoms.
Rather than relying on memory, those with the condition are usually encouraged to keep an ongoing food diary, says Adiana Castro, RDN, a registered dietitian specializing in gut health, and owner of Compass Nutrition in New York City.
“Crohn’s is a chronic disease, and a food and symptom diary is a nonnegotiable, especially if you are newly diagnosed, because it will help you learn how your body responds to your food choices,” she says.
A food diary can help you identify your food triggers and build a specific eating plan that works for you, Castro says. There’s no such thing as a “Crohn’s diet” because each food affects each person differently, and any foods you need to limit or avoid will be highly individual to you and your body.
What Is a Food Diary, and Why Could It Help if You Have Crohn's?
Just like the term implies, a food diary is a log of everything you eat and drink, incorporating all meals and snacks throughout each day. But it can also be more than that when you have Crohn’s, says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
“A food diary can be a helpful way to pay attention not just to what you’re eating, but also to how you’re feeling and the symptoms you’re experiencing,” he says. “By having a record of both your food and any subsequent issues related to Crohn’s, you can often feel like you have more control when managing your condition.”
It can also help you manage your condition more effectively since it often helps you pay closer attention to your body, says Dr. Farhadi. As you get into the habit of jotting down what you’ve eaten and how you’re feeling, you can pinpoint any foods that may be problematic, and adjust as necessary to help prevent Crohn’s flares in the future, he says.
How to Keep a Food Diary for Crohn’s: 3 Tips
Although it’s possible to just write down everything you eat, there’s more to keeping a food diary for Crohn’s than making a simple list. Consider these three tips to make the diary more useful, particularly when it comes to linking foods to subsequent symptoms.
1. Use Whatever Format You Like Best
The most important aspect of keeping a food diary is consistency, says Castro, so it’s helpful to choose a strategy that you will use daily. That might mean using an app or writing in a paper notebook, or even keeping a photo food journal where you snap a picture of each meal and snack.
“The goal is to make it convenient, so you can record your food intake as soon as you’re finished eating and be as detailed as possible,” Castro says.
2. Log Any Symptoms You Have Within a Few Hours of Eating
You’re aiming to assess food tolerance and identify trends by looking at overall patterns, which is why it can help to write down any symptoms you have after eating each food and try to identify patterns, says Castro. However, she warns against anticipating certain symptoms, since that might actually prompt you to magnify issues that would have seemed minor otherwise.
“It’s important to track your symptoms, but you don’t want to expect feeling sick,” she says. “Perception matters, so just try to take it day by day and document what you observe.” In terms of what to record, she suggests logging:
Which foods you ate
Roughly how much you ate of each food (for example, a cup of steamed broccoli or one chicken breast)
Time you ate each food
Gastrointestinal symptoms you have within a few hours after eating the food, like abdominal pain, nausea, bloating, gas, or heartburn
Changes in bowel movements like frequency, volume, or consistency
“Keeping a food journal of potential food triggers may help limit and shorten flare-ups when they occur,” says Castro. “Think of all of this as your personal data bank that allows you to then make mindful food choices that work well for your body in the long run.”
3. Track Non-Gastrointestinal Symptoms, Too
In addition to paying attention to how specific foods might affect your digestion, it’s helpful to be aware of other potential issues as well, says Farhadi. These might seem to come up at random rather than close to mealtimes, but it’s still useful to jot them down, he says. For example, include these in your food diary when you experience them:
Fatigue
Fever
Loss of appetite
Mouth sores
Night sweats
Pain or redness in the eyes
Swollen or painful joints
Difficulty sleeping
“Writing down symptoms like these could help you and your doctor identify patterns that may be related to food but could also be related to when you take your medication, for example,” he says. “The more information you have like this, the better.”
The Takeaway
A food diary is often recommended for those with Crohn’s disease as a way to identify foods that lead to symptom flares.
In addition to tracking food, a diary should also include any symptoms that come up, even if they seem unrelated to what you just ate.
Bring your food diary to appointments with your healthcare team, since it can offer useful information about possible patterns in Crohn’s flares.
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Palamenghi L et al. Food and Inflammatory Bowel Diseases: A scoping review on the impact of food on patients’ psychosocial quality of life. Health & Social Care in the Community. February 17, 2022.
Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.
Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.
She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.
Elizabeth Millard is a freelance writer based in northern Minnesota. She focuses on health, wellness, and fitness, and has written for Runner's World, Bicycling, Self, Women's Health, Men's Health, Prevention, Experience Life, and more. She is an American Council on Exercise–certified personal trainer and a Yoga Alliance-registered yoga teacher. She graduated from Harvard University with a bachelor's degree in English.
