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In this candid episode of Wrestling the Octopus: The IBD Patient Podcast, Rachel and Nigel dive deep into the lived reality of IBD (inflammatory bowel disease) – from emergency symptoms to complex procedures, new medications, bowel prep dilemmas and the importance of patient‑centred care.

Nigel’s Recent Medical Rollercoaster

Nigel recounts a frightening episode of passing blood while urinating – which led to A&E, scans, and ultimately a cystoscopy. 

He also discusses:

• Kidney stones
• An enlarged prostate
• An upcoming OGD with ultrasound to assess his pancreas
• Ongoing issues with low platelets and splenomegaly

This segment highlights how Crohn’s disease and long‑term treatment can intersect with other health conditions, complicating the picture of gut health and overall wellbeing.

Rachel’s Treatment Update

Rachel prepares to start ustekinumab (a biosimilar: Wezenla) for Crohn’s disease:

She also discusses:

• Pre‑biologic screening 
• The value of regular contact with IBD nurses
• How patient experience varies widely across the UK

The Great Bowel Prep Debate

Listeners wrote in asking about split‑dose bowel prep—especially when the second dose must be taken hours before an early‑morning colonoscopy.

Rachel and Nigel share their own strategies:

• Nigel: would take the second dose the night before (but stresses this is personal, not medical advice)
• Rachel: prefers setting an early alarm to avoid bowel prep “activating” on the train

They also reflect on how bowel prep is often worse than the colonoscopy itself:
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The Power—and Pitfalls—of Patient Communities

Rachel and Nigel explore what they see in online IBD groups:

• Anxiety around colonoscopies
• Medication experiences
• Surgery recovery
• Difficulty accessing consultants
• The value of peer support

We also discuss how digital tools like MyChart can both empower and overwhelm patients.

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid