Inflammatory Bowel Disease (IBD) Personal Management Plan

Patient Information

Name: _________________ Date: _________________ Gastroenterologist: _________________

Disease Information

• Type of IBD: □ Crohn's Disease □ Ulcerative Colitis
• Date of Diagnosis: _________________
• Disease Location: _________________

Current Medications

Maintenance Plan

Diet Management

• Follow prescribed diet type: □ Low-FODMAP □ Low-residue □ Other: _________
• Foods to avoid:
  • High-fiber foods during flares
  • Known trigger foods (list): _________________
  • Caffeine and alcohol

Lifestyle Modifications

1. Exercise Plan:

   • Type: Low to moderate intensity
   • Frequency: 3-5 times per week
   • Duration: 20-30 minutes per session

2. Stress Management:

   • Regular relaxation techniques
   • Adequate sleep (7-9 hours)
   • Support group participation

Monitoring Plan

Regular Monitoring

• Blood tests every _____ months
• Colonoscopy every _____ months/years
• Stool tests as needed

Symptom Tracking

Daily monitoring of:

• Bowel movements (frequency and consistency)
• Abdominal pain (1-10 scale)
• Other symptoms: ________________

Emergency Plan

Contact Healthcare Team If:

• Severe abdominal pain
• Blood in stool
• Fever > 101°F (38.3°C)
• Severe diarrhea (>6 movements/day)

Emergency Contacts

• Gastroenterologist: _________________
• Emergency Department: _________________
• IBD Nurse Coordinator: _________________

Follow-up Schedule

Next appointment: _________________

This management plan should be reviewed and updated regularly with your healthcare provider.