Karla Graf, CRNP
Karla Graf, CRNP
A keep-forever guide — free
A food list tells you what you ate. A pattern log tells you what your gut is doing. Two minutes a night, for fourteen nights.
Hi, I'm Karla. If you're here, you've probably been told it's "probably just IBS" and to try more fiber. Maybe you've already cut out gluten, or dairy, or both, and it helped for a week and then stopped helping.
Here's what I see over and over: people arrive certain that a specific food is the problem, and the log shows the food was never the pattern. The timing was.
Fourteen days. You'll see something you can't see day to day.
Any of those, don't log it — get seen. They need ruling out properly, and a two-week diary delays that. This guide is for the person whose serious causes have already been looked for and who is still uncomfortable with no explanation.
You've probably been asked to keep a food diary before, written down everything for a week, handed it over, and been told it looked fine. There's a reason that usually goes nowhere.
A food diary asks "what did you eat." The more useful question is "what happened, when, and what else was going on that day."
This is the part almost nobody is told, and it's the reason your own log can be more informative than another elimination diet.
Food takes a predictable route. Something that bothers you within 30 minutes is being felt high up — stomach, upper small intestine. Something that hits at 1 to 3 hours is happening further down the small intestine. Something at 6 hours or more has reached the large intestine, where most fermentation happens.
So "bread bloats me" is much less useful than "bread bloats me ninety minutes later, and so does onion, and so does apple." The first sentence points at a food. The second points at a mechanism — and mechanisms are what a plan gets built on.
The other thing a plain food list can't show: symptoms that track with your stress, your sleep, or your cycle rather than your plate. Those are common, they're real, and they get missed completely when the only column is "what I ate."
| Column | What to write | Why it matters |
|---|---|---|
| Time | When symptoms started, to the nearest half hour | The single most useful piece of data. It locates the problem in your digestive tract. |
| Gap | Hours since your last meal | Turns "after lunch" into a mechanism. |
| What | The meal, roughly. Don't weigh anything. | Enough to spot a repeat offender, not a nutrition audit. |
| Symptom | Bloating, gas, pain, urgency, reflux, nausea | Different symptoms point different directions. |
| Severity | 1 to 5 | Lets you see trend rather than just presence. |
| Stool | Loose / normal / hard / none | Motility is half the story and the part people skip. |
| Stress | 1 to 5 for the day | Reveals the symptoms that aren't about food at all. |
| Sleep | Hours, roughly | Poor sleep changes gut motility and pain sensitivity. |
| Cycle | Day of cycle, if you have one | Bloating that tracks the cycle is a different conversation. |
Two rules. Don't change your diet while you log — you're recording your normal, not running an experiment. And fill it in the same night, not three days later from memory.
Print this. Two minutes before bed. Fourteen nights.
| Day | Time | Gap | What you ate | Symptom | 1–5 | Stool | Stress | Sleep | Cycle |
|---|---|---|---|---|---|---|---|---|---|
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| 14 |
On day fifteen, lay all fourteen rows side by side and look for which of these you recognise. These are patterns worth asking about — not diagnoses, and not conclusions you should act on alone.
Flat stomach on waking, distended by evening, repeating daily. This is a fermentation-shaped pattern and it's one of the reasons breath testing for small intestinal overgrowth exists. Worth reading alongside SIBO.
Onion, apple, wheat, beans and milk have little in common on a plate but plenty in common in how they're fermented. When the offenders look random but the timing doesn't, the food isn't the variable — the process is.
Fast onset points higher up. Worth asking about stomach acid, how well food is being broken down early, and what medications might be involved.
Real, common, and not the same as "it's in your head." The gut and brain talk constantly in both directions. It means the plan needs to address that traffic rather than only your plate.
If the worst days land in the same week every month, that's a hormone-and-gut conversation rather than a food one. See why those travel together.
Alternating constipation and looseness points at motility — the timing of movement through the system — which is a different target than "what did I eat."
This is a genuinely useful result and people undervalue it. It argues against a simple food trigger and moves the question toward what else is going on — thyroid, iron, medication, sleep, or something structural that deserves ruling out properly.
Take it to whoever you see next. A clinician handed fourteen days of timed, structured observation has something to work with, and it is a great deal harder to wave off than "I'm bloated a lot."
If you want the questions to ask alongside it, take Questions Your Provider Should Have Asked too. Both are free and neither requires anything from us.
If you'd rather not decode it alone
That's what a Clarity Visit is. You bring this log and whatever labs you already have, and Karla — a nurse practitioner, for a full unhurried hour — reads your history, your symptoms and your numbers as one picture, then puts a written plan in plain language in your hands within 48 hours. $397. Adults in Pennsylvania, by telehealth.
And if your log points somewhere that isn't us, she'll tell you that. A no is a fine outcome here.
See what the Clarity Visit includesNo account, no sales call.
More on the gut: what bloating can mean or the the overview · SIBO · what a GI-MAP reads · why “it’s just IBS” isn’t an answer · why gut, thyroid and hormones travel together.