Make a one-page symptom summary for your appointment

Fill in what you know, skip what you don’t, and print one page for your GP or dietitian. It follows the order in our guide to summarising digestive symptoms for a GP.

Your name (optional)Appointment with (optional)Diary dates covered (optional)

01Main concernThe symptom or change I most want to discussIn your own words, for example “bloating most evenings, sometimes painful”.

02TimelineWhen it beganA month or season is fine.How often it happens and how long it lastsFor example “4–5 days a week, a few hours each time”.Whether it has changedGetting worse, better, different, or about the same.

03Bowel patternFrequency, appearance, urgency, straining or pain, if relevantPlain words are enough. Add a Bristol stool scale type if you use one.

04Possible associationsWhat tends to happen before or alongside itFoods, timing, sleep, stress, periods or routine you have noticed more than once.Times it did not follow that patternWhat is missing or uncertain in my record

05ImpactWhat it stops me doing or makes harderSleep, work, eating, exercise, travel or social plans.

06Other contextMedicines and supplementsIncluding doses if you know them.Recent illness, existing conditions and relevant family historyPrevious appointments or tests for this

07My questionsQuestion 1For example “What should be ruled out?” or “Who do I contact if it changes?”Question 2Question 3

Your summary

Digestive symptom summary

Name: For: Prepared: Diary dates:

Start typing above and your summary appears here.

Main concern

The symptom or change I most want to discuss

Timeline

When it began
How often it happens and how long it lasts
Whether it has changed

Bowel pattern

Frequency, appearance, urgency, straining or pain, if relevant

Possible associations

What tends to happen before or alongside it
Times it did not follow that pattern
What is missing or uncertain in my record

Impact

What it stops me doing or makes harder

Other context

Medicines and supplements
Recent illness, existing conditions and relevant family history
Previous appointments or tests for this

My questions

Question 1
Question 2
Question 3

More help: what to bring to a dietitian appointment, and a printable food and symptom diary to fill in before your next one.

If you would rather keep meals and symptoms on one timeline as they happen, get GutBloom on Google Play.