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An MRI, a phone call, and four words nobody wants to hear: “You have a perforated bowel.” Zach Koscuik was on the road to a comedy gig when Crohn’s disease forced yet another hard pivot, adding to a 25-year history that includes perianal Crohn’s, fistulas, abscesses, emergency surgeries, biologics, and three ileocolonic resections. We talk with him about what it’s like to grow up sick, manage the stigma that makes people minimize inflammatory bowel disease, and keep showing up to school, work, and life when your body is always negotiating the nearest bathroom.

Then the story takes a turn into the world of clinical trials and high-stakes medicine. Zach explains how severe disease and short bowel complications pushed his team toward an autologous stem cell transplant, a process that essentially wipes out and restarts the immune system. We get specific about the testing, chemo, isolation, and the surreal experience of being treated on a cancer floor without having cancer, plus the very real impact of insurance decisions that kept him hospitalized for 43 days.

The payoff lands with the kind of news IBD patients barely let themselves hope for: a one-year follow-up colonoscopy that comes back completely clean. We also keep it honest about what remains, including motility issues, joint pain, and the mental aftershocks of medical trauma. Zach closes with a simple challenge for the Crohn’s and colitis community: practice equal empathy, because two people can share a diagnosis and live totally different realities. If this conversation hits home, subscribe, share the episode with a friend, and leave a review so more people living with IBD can find it.

Links: 

• Find Zach on Instagram
• Information on the stem cell trial that Zach did
• Stem Cell Therapy clinical trial site- Clinicaltrials.gov

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