A few months ago, while cleaning out an old work bag, I found a journal from about 10 years ago. As a writer, I’ve always kept journals, whether to jot down notes and ideas, reflect on my day, or vent my emotions rather than keeping them bottled up inside. The journal I found in my work bag was different, though. It was my Crohn’s disease journal from when my diagnosis was still fairly new and my disease was at its most severe. This was the journal that helped me discover my triggers — the foods and activities that caused and exacerbated my flares.
Tracking my diet was the easiest but most time-consuming part of keeping my journal. The point of keeping a food diary wasn’t to count calories but to log every meal, drink, and snack that went into my digestive system. I noted everything from ingredients to how the food was prepared to whether I was able to finish everything, or if I had no appetite and had to force myself to eat just to have something in my stomach.
Of course, what goes in must go out. I’ll spare the details, but I recorded how my body reacted to what I ate and drank. If I became gassy or bloated, I wrote it down. If I had an abdominal cramp, I wrote it down. If I had a bowel movement, I not only wrote it down, I documented every disgusting detail to monitor the severity.
After a month or two, I started recognizing connections between what I ate and how I felt. Ironically, the healthier the food, the worse it made my symptoms. Things like salad, fresh fruit and vegetables, and whole grains caused severe bloating, cramping, and diarrhea. But when I had white rice and ground beef and mashed potatoes, I could tolerate eating and was able to keep everything down — and in, for the most part.
I discovered that I was becoming lactose intolerant, too. While I could eat yogurt and cheese, ice cream and milk made me miserable. I was relieved to know spicy food didn’t affect me. Finding out that I had to give up jalapeños, Tabasco sauce, and Sriracha sauce would have been more heartbreaking than receiving my Crohn’s diagnosis!
By keeping a food log, I realized that when flares were caused by something I ate, they usually happened immediately or within an hour of digestion. But what about the times when I had an episode that didn’t occur after eating?
If I had a flare or heightened symptoms that I knew weren’t caused by my food triggers, I had to do some investigative work and retrace the steps of my physical, emotional, and mental states at the time. Eventually, patterns emerged. Because I was already keeping a food diary, I was able to determine that when my normal eating schedule was disrupted or if I wasn’t drinking enough fluids, my stomach would rumble in that familiar, unpleasant IBD way. If I was already having a severe flare, moderate exercise or even light activity like walking would bring about the urgency to go to the restroom.
I noticed that my symptoms would get worse at the same time each month, so I could use them to predict my menstrual cycle, and vice versa. Journaling eventually led me to discover that my main trigger is stress, one that still affects me now that I’m in remission. Whether I’m pushing myself to meet a project deadline or I’m emotionally drained, I know to brace myself for the inevitable cramping and trips to the bathroom.
Although I mainly kept my IBD journal on me at all times to record my diet and symptoms, it came in handy for writing down questions to ask and keeping notes to discuss with my doctor at future appointments. I also was able to write down my doctor’s answers and comments for future reference, and both my doctor and I found it useful when we couldn’t remember what we had discussed previously.
The notebook I found in my old work bag was specifically for tracking the effects of Crohn’s on my physical health. In future columns, I’ll talk about the separate journals I kept to document the emotional roller coaster and spiritual growth I experienced with this disease.
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