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Ulcerative Colitis: Starting a Food Diary

Keeping a diary of food and symptoms may help you expand your menu.

Keeping an Ulcerative Colitis Diary: 5 Tips for Top Results continued...

•         Record amounts and how foods are prepared. Some people are bothered by large servings of chocolate but untroubled by a bite-sized piece. Fried chicken may exacerbate symptoms while grilled chicken goes down fine. Write down not just what you ate but how much and how it was prepared.

•         Keep track of your ulcerative colitis symptoms. Some people use a scale of 1 to 10 to describe how they're feeling. Others prefer written notes. Use whatever system helps you be as accurate as possible.

•         Don't be afraid to experiment. While keeping a food-and-symptom diary, try small amounts of foods that you tend to avoid for fear they'll cause problems. That way you can test whether they really do spell trouble for you. If a large serving of something bothers you, try cutting the serving size in half. Remember that your goal is to eat as wide a variety of foods as you can.

•         Stick with your diary for at least three weeks. You'll need that much time to observe patterns. Remember, too, that you can always go back to keeping a food-and-symptom diary if you introduce new foods to your diet.

What Will a Diary Tell You?

In some cases, drawing conclusions from your diary can be straightforward. "If a certain food always seems to give you problems afterwards, you know to avoid it," says Walter J. Coyle, MD, director of the gastrointestinal program at Scripps Clinic Medical Center In La Jolla, Calif.

Often the patterns aren't quite so simple. Meals, after all, are made up of many different foods, in different preparations and different amounts. The amount of time it takes food to reach the large intestines, where ulcerative colitis is focused, also varies for different foods. Pinpointing the real problem may take trial and error.

What's more, some foods are so ubiquitous that it's hard to eliminate them. "A lot of people say they're intolerant to soy, for instance," Coyle tells WebMD. "If you look at food labels, there's soy in almost everything. So it's very hard to know if soy is a problem -- and even harder to avoid it."

Still, a food diary can provide useful insights -- and yield some nice surprises. "Some people who think of themselves as lactose intolerant may discover that they can tolerate small amounts of milk and other dairy products," Dalessandro says. Others may discover that a food they never suspected makes their symptoms worse.

Ultimately, your goal should be to end up with a diet that offers you as much variety as possible. "Some people really are intolerant to certain foods, and then it's wise to avoid such foods," says Rubin. "But the goal is to control the disease and improve quality of life. We don't want patients to have to avoid a long list of foods that makes it impossible to eat normally."

If a food-and-symptom diary is helpful for pinpointing troublemakers in your diet, it's just as useful for discovering what foods you can welcome back into your life. And since ulcerative colitis and other inflammatory bowel diseases are chronic and usually lifelong, the more normal and varied a diet you follow, the better your quality of life will be.

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Reviewed on December 14, 2010

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