Inflammatory Bowel Disease Action Plan

Feeling Good - Green Zone: No or minimal symptoms

• Pain is absent or tolerable; at your baseline

• Bowel movements are normal for you; no pain or blood when going to the bathroom

• Energy level is good; you can attend school and do activities/hobbies

• Appetite is good; you can eat all meals and snacks

Take Action!

• Use a hot pack or take acetaminophen (Tylenol®) for your pain

• Check for blood in toilet or on toilet paper

• Stay active in school and social activities

• Eat a balanced diet - avoid your trigger foods

• Take your medicine every day

• Attend your appointments

Feeling Bad - Yellow Zone: Mild symptoms are present or starting to increase

• An increase in bowel movements, lasting over 24 hours

• A change in the look of stools and/or streaks of blood or mucus, lasting over 24 hours

• Feeling like you have to run to the bathroom

• An increase in mild belly cramping or rectal pain

• A pattern of waking up early or overnight with bowel movements, lasting over 24 hours

• Energy level is decreased; you can attend school but feel tired by the afternoon

• Loss of appetite; you can eat 75% of meals and snacks

Take Action! 

• Use your pain management strategies

• Avoid your trigger foods

• Take a nap after school or skip practice today

• Decrease screen time

• Keep your stress level down; try deep breathing

• Take your medicine every day

• Tell your caregiver about your symptoms

• Consider contacting your IBD team for next steps via MyCHOP or phone

Feeling Worse! - Red Zone: Yellow Zone symptoms present for more than 2 days or worsening symptoms:

• Ongoing belly or rectal pain or new rectal drainage

• Blood in most bowel movements

• Diarrhea or increase in bowel movements

• Vomiting lasting more than 3 hours or vomit that is green (bile)

• Fever (greater than 100.4° F/38° C) with an unknown source (no recent sick contacts)

• Missing school or too tired for activities

• Loss of appetite; able to eat only 50% meals and snacks

• New symptoms: rashes, mouth sores, red, swollen eyes, joint pain, or swelling

Call your CHOP IBD team:

• Call 215-590-3630 Monday - Friday. Weekends/evenings call 215-590-1000 and ask to page the GI Fellow on call.

• To schedule an appointment for infusions in the GI Suite, call 215-590-3326.

• Contact your primary care provider for general health questions or symptoms not related to IBD.

• For Medical Emergencies, call 911!

Center for Pediatric Inflammatory Bowel Disease

Reviewed February 2025 by Jamie Scaramuzzi, BSN, RN, CPN