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Five years post J-pouch surgery sounds like a finish line, but our bodies do not read the brochure. We’re together in person for a live catch-up with our favorite recurring guest and IBD Registered Dietitian, Stacey Collins, and we get real about what changes with time and what still blindsides you when you live with a J-Pouch after IBD.

We talk through the wins that matter most day to day: more capacity, less urgency, and the quiet joy of doing normal things without panic, like waiting in line, taking long road trips, hiking, skiing, and traveling. Then we dig into the stuff patients whisper about but rarely get warned about, especially gas pain. We break down what it feels like, why it can block emptying, what actually helps (yes, including “toilet yoga”), and why travel, altitude, fasting, dehydration, carbonation, and food additives can make symptoms spike.

We also cover the scary gray zones: when symptoms feel like a Crohn’s flare but turn out to be SIBO, why antibiotics may be part of J-pouch life, and how to rebuild the gut microbiome afterward with food you can tolerate. Finally, we get blunt about the “surgery is curative” myth, the need for ongoing monitoring (iron deficiency anemia, B12, folate, fatigue), and what better post-op care should look like, including pelvic floor physical therapy and honest expectations at 3, 6, and 12 months.

If you found this helpful, subscribe, share it with someone who needs it, and leave a review. What’s one thing you wish your care team had told you before surgery?

Links:

• Stacey's website- sign up for her waiting list, find resources
• Stacey's additives guide
• Stacey's oral rehydration guide
• Info about SIBO- Mayo Clinic
• Info about the ENIGMA Study- National Institutes of Health
• Info about the ENGIBMA Study from Stacey's website

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The word “surgery” can feel like a threat when you’re young and already worn down by Crohn’s disease. Michael Morgan, author of *The Secret Life of Crohn’s*, joins us to talk about being diagnosed at age 10, cycling through medications, and living with the kind of urgency that forces you to plan every minute around toilets, school schedules, and the fear of being noticed. We get into the part people don’t always see: the constant anxiety, the shrinking world, and how much mental energy IBD can steal long before anyone calls it mental health.

Michael also shares what it was like to hear ostomy surgery discussed as a teenager, the misconceptions that fueled his fear, and the moment he realized life on the other side could be bigger than the life he was trying to protect. We talk about the adjustment period, confidence building, and why so many people with ostomies describe freedom and relief once their disease is under better control.

From there, we dig into practical realities: asking schools for accommodations, using tools that make bathroom access easier, staying on top of Crohn’s management even after major surgery, and navigating rare symptoms like inflammatory disease in the mouth. And yes, we go deep on travel with an ostomy, including packing supplies, hostel bathrooms, and the small “tricks” that make big adventures possible.

If you’re facing a big treatment decision, supporting a child with IBD, or trying to make your world bigger again, this conversation will meet you where you are. Subscribe, leave a review, and share this with someone who needs a little more hope and a lot more real talk.

Links:

• More of Michael's Story- Crohn's & Colitis UK
• Order Michael's book
• Article about Michael and his book- Hackney Citizen
• Traveling with an ostomy- United Ostomy Association

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Medical care can be doing everything “right” and you can still feel wrecked, anxious, and trapped in a never-ending cycle of symptoms, appointments, and fear. That gap is where GI psychology lives, and it’s why we wanted Dr. Anna Katherine “AK” Black. AK is a licensed clinical health psychologist at GI Psychology, with a focus on gut-brain therapies, trauma-informed care, and medical fatigue in chronic illness.

We get into what clinical hypnosis actually is (no stage tricks, no mind control) and why gut-directed hypnotherapy has decades of research behind it for GI conditions. AK explains the gut-brain connection in plain language, including how stress can hijack the system, how visceral hypersensitivity turns the volume up on sensations, and why you can’t just tell your gut to “calm down” with conscious thoughts alone. We also talk about how fear and pain overlap, and why techniques that shift the nervous system toward parasympathetic regulation can change real physical symptoms.

Then we name the thing so many people feel but rarely hear described: medical fatigue. If you’ve ever canceled yet another appointment, struggled to keep up with meds and procedures, or felt judged as “noncompliant,” this conversation puts words to that burnout and offers practical next steps. We also cover trauma-informed care, what providers can do with better language and screening, and why integrated teams work best. AK shares resources and explains the Crohn’s & Colitis Foundation partnership group that combines community with skills like CBT and hypnosis.

Subscribe for more real talk about living with IBD, share this with someone who needs it, and please leave a rating and review so more people can find the show. What part of the gut-brain story hit closest to home?

Links:

• Join the IBD Psychotherapy Group
• Info on Gut-Directed Hypnotherapy

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