The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome.
BACKGROUND
Paper food and gastrointestinal (GI) symptom journals are used to help irritable bowel syndrome (IBS) patients determine potential trigger foods. The primary aim of this study was to evaluate the feasibility, usability, and clinical utility of such journals as a data collection tool. A secondary aim was to explore a method for analyzing journal data to describe patterns of diet and symptoms.


METHODS
Participants (N=17) were asked to log three sets of 3-day food and symptom journals over a 15-day period. Feasibility was evaluated by journal completion rates, symptom logging compliance, and logging fatigability. The feasibility, usability, and clinical utility of journaling were also assessed by a customized evaluation and exit interview. For each journal, regression analyses were conducted to examine relationships between key meal nutrients and subsequent symptoms.


RESULTS
Most participants were young (mean age 35±12) Caucasian (N=13) women (N=14). Journal completion rates were 100% for all participants with no logging fatigability. Over half perceived paper journaling of food and symptoms as feasible, usable, and clinically useful. Thirteen participants demonstrated a strong association with at least one symptom and meal nutrient. Patterns of associations differed among participants.


CONCLUSIONS
Paper journaling of food and GI symptoms for 9 days over a 15-day period appeared to be a feasible and usable data collection tool for IBS patients. Over half perceived journaling as at least somewhat clinically useful. Findings from this study support the anecdote that food trigger(s) and associated symptom(s) vary for each individual.
Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA.
J K
JK
Zia
Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, USA.
C-F
CF
Chung
Department of Computer Science & Engineering, University of Washington, Seattle, WA, USA.
J
J
Schroeder
Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, USA.
S A
SA
Munson
Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, USA.
J A
JA
Kientz
Department of Computer Science & Engineering, University of Washington, Seattle, WA, USA.
J
J
Fogarty
Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, USA.
E
E
Bales
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
J M
JM
Schenk
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
M M
MM
Heitkemper
D000328:Adult; D015930:Diet Records; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
Irritable Bowel Syndrome; alternative medicine; food intolerances; nutrition