IBD: 5 Things You Should Be Tracking

5 Things You Should Be Tracking When You Have IBD

5 Things You Should Be Tracking When You Have IBD
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When you live with a form of inflammatory bowel disease (IBD) like Crohn’s disease or ulcerative colitis (UC), keeping track of patterns in your bathroom habits, symptoms, and other factors that affect your condition can help you manage your care effectively and feel your best.

“Patients are key to keeping on top of [their IBD], and their symptoms help to guide if further testing or changes in medications are needed,” says Svetang Desai, MD, a gastroenterologist at Houston Methodist Sugar Land Hospital in Sugar Land, Texas.

So what specifically should you be keeping tabs on? While tracking may look different for different people, in general, there are a few details you’ll want to log. Here’s what to keep track of, when tracking is important, and when it might be okay to stop or ease up.

1. Bowel Movement Changes

A change in your bowel habits is one of the signs that you may be headed for a flare, so it’s crucial to keep tabs on any shifts away from what’s typical for you.

 Focus on recording a few key characteristics instead of trying to get down every detail, says William Park, MD, a gastroenterologist with MedStar Health in Washington, DC.
These include:

  • Frequency How many times are you going to the bathroom, and are you waking up at night to go?
  • Consistency Are your stools formed, loose, or watery?
  • Urgency Do you get hit with a sudden need to go?
  • Blood in your stool, which may appear red or black
  • Accidents or leaking
  • Cramping or pain (including rectal pain) during bowel movements

You should also record the date and time that your bowel changes started, says Dr. Desai.

2. Gastrointestinal Symptoms

Not every stomach twinge means that your IBD is headed downhill. But gastrointestinal symptoms that have changed or become more severe are other common signs of worsening IBD or IBD that isn’t well-controlled, so they’re important to track. You should note:

  • Abdominal pain, cramping, or discomfort
  • Nausea
  • Vomiting
  • Bloating

Rate the intensity of your abdominal pain on a scale from 1 to 10 so you and your doctor can track how severe the problem is and whether it’s getting worse, Desai says. Again, be sure to include the date and time when your symptoms started.

3. Non-Gastrointestinal Symptoms

IBD can cause extraintestinal manifestations (EIMs), or symptoms in other parts of your body. “These can sometimes be related to IBD itself, complications of the disease, or its treatment,” says Dr. Park.

You should track:

  • New or worsening joint pain, stiffness, or swelling
  • Skin changes such as rashes, sores, skin tags, openings (fistulas), or tears (fissures)
  • Mouth sores
  • Eye pain, dryness, itching or burning, vision changes, sensitivity to light, or redness

Similar to abdominal symptoms, you should note when the symptoms started and rate any pain on a scale of 1 to 10.

4. Dietary Triggers

What you eat won’t actually cause a flare. But it can definitely make your symptoms act up, so you feel worse.

“Certain triggers […] can lead to diarrhea and potentially abdominal cramping,” says Harold Boutte, MD, a gastroenterologist with the Northwestern Medical Group in Chicago.
That said, food triggers can be different for different people. So you’ll need to keep a food journal to find out which foods affect you. For a few weeks, write down what you eat and any symptoms that develop afterward.

 If you need help identifying possible triggers or are having trouble figuring out what to eat, your gastroenterologist can refer you to a registered dietitian who specializes in IBD.

5. Sleep and Stress Levels

Poor sleep and high stress levels may both be tied to IBD flares.

So, paying attention to how you’re doing with both may help you understand more about why your symptoms could be acting up, Dr. Boutte says. You can also share the findings with your gastroenterologist and discuss whether lifestyle changes like more sleep or better stress management could support your current IBD treatment plan.

Other Things to Know About Tracking

There are no rules when it comes to tracking for your IBD. It’s about finding what works for you and helps you feel your best. Here are some important things to keep in mind.

  • Track important details, but try not to obsess. The goal of tracking is to look for patterns that could be related to your IBD. “The point is not to become overly focused on every sensation in your body,” says Park.
  • Use the tools that you prefer. A notebook, the notes app on your phone, or a symptom tracking app (like Aidy or Bearable) can all get the job done. The key is that you track the same things consistently to spot trends, Boutte says.
  • You may not need to track all the time. “Most people don't need to track forever. It's most useful right after diagnosis, when starting or changing a medication, during a flare, and before a visit,” says Park, who adds that once you’ve been stable for a while, you may only need to start tracking again if your symptoms start acting up.
EDITORIAL SOURCES
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Resources
  1. Krugliak Cleveland N. How Can You Tell If Your IBD Is Getting Worse? Chicago Medicine. March 23, 2023.
  2. Extraintestinal Complications of IBD. Crohn’s & Colitis Foundation.
  3. Eye Complications. Crohn’s & Colitis Foundation. January 2015.
  4. Food. Crohn’s & Colitis Foundation.
  5. Keep a Food Diary to Track Allergies or Intolerances. Harvard Health Publishing.
  6. Hirten RP et al. Wearable Devices Identify Altered Sleep Characteristics and Sleep Trajectories in Active Inflammatory Bowel Disease. Clinical Gastroenterology and Hepatology. March 2026.
  7. Sauk JS et al. High Perceived Stress is Associated With Increased Risk of Ulcerative Colitis Clinical Flares. Clinical Gastroenterology & Hepatology. March 2023.

Yuying Luo, MD

Medical Reviewer

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 ...

Marygrace Taylor

Marygrace Taylor

Author

Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditi...