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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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