This FREE Food Log and gastrointestinal (GI) Symptom Tracker helps you (or your patients) track the foods you eat and any reactions or symptoms that follow.

The 1 Week Food Log and GI Symptom Tracker helps you track:

Column 1: Date and time of meal/snack

Column 2: Foods consumed at meal/snack

Column 3: Beverages consumed

Column 4: GI symptoms or reactions to food/beverages:

  • Diarrhea – how often, stool texture, urgency
  • Constipation – how often, stool texture, pain, complete/incomplete elimination of bowel movements
  • Gas – frequency
  • Bloating – extent of bloating, time of day, pain
  • Abdominal pain – increased/decreased intensity related to symptoms above

Column 5: Stress level

  • Scale between 1 and 10
    • 1 = low stress level
    • 10 = high stress level

Column 6: Emotions/Feelings

  • Examples: excited, sad, anxious, hopeful, surprised, scared, angry, happy, etc.

Column 7: Hunger/Fullness Scale

  • Scale between 1 and 10
  1. Starving – dizzy, lightheaded, feeling weak
  2. Very hungry – you could eat anything
  3. Hungry – not uncomfortable, but ready to eat
  4. Slightly hungry – you can wait to eat
  5. Neutral
  6. Could eat more, but filling up
  7. Full, your hunger is gone
  8. To full, feeling some discomfort
  9. Stuffed and uncomfortable
  10. Thanksgiving full – Uncomfortably sick

**Target = maintain hunger/fullness between 3 and 7 to prevent starvation/binging cycles.

Hours of sleep.

Physical activity.

I hope this is helpful to you and your patients.

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