Wrestling the Octopus (IBD) – Details, episodes & analysis

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Wrestling the Octopus (IBD)

Rachel (@bottomlineibd) and Nigel (@crohnoid)

Health & Fitness

Frequency: 1 episode/12d. Total Eps: 39

Two long-term IBD patients, Rachel and Nigel, share their experiences and perspectives on living with inflammatory bowel disease (Crohn's disease and ulcerative colitis).

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Data updated on 01/08/2026

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https://www.theironclinic.com/
2 shares
https://www.mdpi.com/2624-5647/7/1/18
2 shares

https://www.facebook.com/ProfessorJulianWalters/
1 share

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Score global : 38%

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#20 Nigel reflects on 15 years post-Crohn's op, and a life-changing experience

Saturday, October 25, 2025 • Duration 22:19

The tables are turned in this episode! Now Rachel interviews Nigel about his life-changing bowel surgery in 2010. Fifteen years on, Nigel reflects on the symptoms that led to his Crohn's surgery, the emotional and practical preparations, and the highs and lows of recovery - including living with a temporary stoma and navigating postoperative ileus.

With his trademark candid storytelling and humour, Nigel shares how planning, shared decision-making and trust in his healthcare team helped him transform fear into confidence. A must-listen for anyone facing IBD surgery or supporting someone who is.

🧠 Key Discussion Points

The inflammatory bowel disease symptoms that led to surgery: stricture, pain, fistulas, and the infamous “octopus” scan
What “semi-elective” surgery means and why it matters
Emotional and practical preparation: writing a will, planning recovery, and managing expectations
The psychological impact of being treated at St Thomas’ Hospital
Nigel’s experience with a temporary stoma - from initial shock to newfound confidence
The challenges of postoperative ileus and nasogastric tubes
The importance of shared decision-making and asking the right questions
How surgery reshaped Nigel’s relationship with healthcare and his own resilience

📌 Listener Takeaways

Surgery can be life-saving and life-enhancing - not just a last resort
Planning ahead (emotionally, practically, legally) can ease the stress of major treatment
Hospital environment and staff support play a huge role in recovery
Temporary stomas can offer unexpected benefits - including confidence and freedom
Postoperative challenges like ileus are real and difficult, but manageable with support
A positive surgical experience can reshape your relationship with healthcare
Ask questions, understand your options, and prepare realistically
Shared decision-making empowers patients and improves outcomes

📣 Where to Listen

All episodes of Wrestling the Octopus are available on Apple Podcasts, Spotify, Amazon Music, or wherever you get your podcasts.

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

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#19 Rachel reflects on staying in Crohn's remission, four years after stopping infliximab

Saturday, October 25, 2025 • Duration 20:40

In this anniversary special, Nigel interviews me about my decision to stop taking medication (infliximab, aka Remicade) for my inflammatory bowel disease, and what reflections I have on staying in remission four years later.

Discussion Points

My rationale for stopping infliximab after nearly a decade of IBD remission
The emotional weight of sharing my decision publicly and the need for sensitivity
The importance of not being labeled “anti-medication” when choosing to de-escalate
How my consultant’s support helped with the decision
Life stressors post-withdrawal — bereavement, menopause, moving house - and the surprising lack of impact on my Crohn's disease
The critical role of monitoring: calprotectin, blood tests, colonoscopy and patient responsibility
Nigel’s contrasting experience with vedolizumab and the discovery of small bowel inflammation via capsule endoscopy
The need for healthcare professionals to embrace and not shut down conversations about drug withdrawal

📌 Listener Takeaways

Every IBD journey is unique - comparison is unhelpful, autonomy is essential
Coming off medication is not a rejection of medicine, but a personal trial
Healthcare professionals should be open to discussing drug withdrawal, even if they don’t recommend it
Life context and support systems are crucial when making treatment decisions
Monitoring is non-negotiable: calprotectin, bloods, colonoscopy, and patient engagement are key
Don’t rely solely on how you feel — tests can reveal hidden inflammation
Patients must take ownership of their health, especially when off medication

🎯 Final Messages

To Patients: Only consider drug withdrawal if you feel truly ready. Examine your life context, support systems and emotional readiness. Don’t let others pressure you - this is your decision, and your health.

To Healthcare Professionals: Embrace conversations about drug withdrawal, even if you disagree. Patients need open dialogue, not closed doors. Your support can make all the difference in helping them navigate their choices safely.

#18 When long-term stability on a Crohn's drug meets a curveball: an IBD patient's story

Thursday, October 23, 2025 • Duration 45:16

Meet Olie Bosley.

Olie is an IT and cybersecurity expert from Oxford, UK who has suffered from Crohn's disease symptoms for nearly 30 years.

We invited Olie to join us for this episode as he has an important story to share: what happens when the drug that has kept you well for so long - in his case Humira (adalimumab) - without notice causes you side effects that mean you need to stop taking it.

Olie speaks with candour to Nigel and me on the practical and psychological challenges this brings a patient who hitherto had well controlled inflammatory bowel disease. His story is a testament to resilience, advocating for oneself and the importance on inter-department communication when treating IBD patients.

🔍 What You’ll Learn

How a childhood injury may have shaped Olie’s health trajectory
The possible link between seronegative arthritis and Crohn’s disease
Why Olie delayed his first colonoscopy... and what changed his mind
The impact of NSAIDs on gut health and Crohn’s progression
Olie’s experience with methotrexate, azathioprine, Humira, infliximab, ustekinumab and Rinvoq
The overlooked reality of bile acid malabsorption after TI surgery
How UVB therapy helped resolve a Humira-related skin reaction
The importance of communication between rheumatology, dermatology and IBD teams

You can follow Olie Bosley on X (@Olski).

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

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#17 Understanding the gut-brain axis in IBD - with clinical psychologist, Dr Gita Robson

Saturday, October 11, 2025 • Duration 21:42

In this episode, we gaze deep into the gut-brain axis with Dr. Gita Robson, a clinical psychologist who specialises in gastroenterology. Our brains and guts chatter in both directions constantly, and we wanted to understand if this had an implications in how Crohn's and ulcerative colitis patients can better manage their disease.

🔍 What We Cover

Why the gut might be our “first brain”
The bidirectional nature of the gut-brain axis
How inflammation, stress and mood are interconnected
The vagus nerve’s role in gut-brain communication
Microbiome diversity and its impact on immunity and mental health
The influence of lifestyle factors - including pets, sleep and exercise
Psychological therapies that reduce inflammation and improve IBD outcomes
Strategies for pain management and building a healthier relationship with discomfort
The impact of sleep disruption on digestion, mood and inflammation
How small changes can break the cycle of stress and flare-ups

💡 Key Takeaways

The gut-brain axis is a two-way street: what happens in your gut affects your brain and your mental state can influence gut function.
Stress, anxiety, and depression can worsen IBD symptoms and inflammation - but they’re also modifiable.
Therapies like CBT, ACT and mindfulness-based stress reduction show promise in improving both mood and inflammatory markers.
Lifestyle factors - including diet, sleep, physical activity, and even pet ownership - shape your microbiome and mental health.
Pain management isn’t just about distraction - it’s about changing how we relate to pain and reclaiming meaningful activities.
Sleep disruption can trigger a cascade of stress responses that affect digestion, mood and inflammation.
Even the smallest change such as a walk, a conversation or a moment of connection can help break the cycle.

📚 Resources Mentioned

NICE guidelines on first-line treatment for depression
Research from King’s College London on psychological interventions and inflammatory biomarkers
Studies on microbiome diversity and depression in IBD

#16 Learning the basics of diet in IBD - with dietitian Dearbhaile O'Hanlon

Wednesday, September 24, 2025 • Duration 32:19

In Episode 16 of Wrestling the Octopus: The IBD Patient Podcast, we're talking a perennial favourite with Crohn's and UC patients: diet and nutrition in inflammatory bowel disease. Our expert guest is Dearbhaile O'Hanlon, principal gastroenterology dietitian at Guy's & St Thomas' Hospital in London, UK.

We discuss everything from emulsifiers and ultra-processed foods to prebiotics, probiotics and the Mediterranean diet, Nigel shares his journey through a food additive trial (and his now-famous homemade bread), while Rachel reflects on the challenge of distinguishing flares from functional symptoms. Whether you’re newly diagnosed or you've had inflammatory bowel disease for years, this episode will give you a great overview of diet in IBD.

Key Topics Covered:

🍽️ Can diet cause IBD? What the evidence says
🥣 Exclusive enteral nutrition vs Crohn’s Disease Exclusion Diet
🥗 Mediterranean diet: a safe bet for remission?
🧪 Emulsifiers, ultra-processed foods & emerging research
🧬 Prebiotics vs probiotics: what’s the difference, and do they help?
🚽 “Evacuate!” moments: food triggers vs flares vs functional symptoms
🧠 Gut-brain signaling and why some foods are louder than others
🩺 Low FODMAP diet: when and how to trial it safely
🧻 Diet tips for stoma management, bloating, and gas
🌾 Soluble vs insoluble fibre: what they are and where to find them
🧬 Strictures and modified fibre diets: what’s safe, what’s risky
📱 Food diaries and apps: helpful tools or homework overload?
🌳 Bark, miracle cures & internet myths: how to spot misinformation

What You Will Learn

There’s no one-size-fits-all IBD diet, but there are patterns worth exploring
Ultra-processed foods and certain emulsifiers may play a role in inflammation
Prebiotics (like onions, garlic, pulses) can be beneficia but also bloating triggers
Probiotics may help some people with UC, but evidence is mixed and costs can be high
If you’re in remission but still sensitive, it might be functional symptoms but not active inflammation
For stoma care: chew well, watch fizzy drinks and caffeine and consider a gentle food challenge process

#15 Understanding bile acid diarrhoea / malabsorption in IBD with Professor Julian Walters

Thursday, September 11, 2025 • Duration 33:29

In Episode 15 of Wrestling the Octopus: the IBD Patient Podcast, Nigel and I cover a topic that receives not nearly as much attention as it should: Bile Acid Diarrhoea (BAD) / Bile Acid Malabsorption (BAM) in Crohn's disease. Our expert guest is gastroenterologist, Professor Julian Walters from Imperial College London in the UK.

Through Nigel's story, we also get a candid view of what BAM feels like for inflammatory bowel disease patients who have had their terminal ileum removed.

What You'll Learn In this Episode

What is BAD/BAM? How bile acids normally work versus what happens when they’re not reabsorbed properly, especially in IBD patients with ileal disease or resection.

Updated terminology: Why “bile acid diarrhoea” is now preferred over “bile acid malabsorption,” and what that means for diagnosis and treatment.

Common causes of BAD: Crohn’s disease, gallbladder removal and genetic variants that lead to excess bile acid production.

How to get diagnosed: A breakdown of the SeHCAT scan, C4 blood test and why access to testing varies across the UK.

Treatment options that work: From bile acid sequestrants (like colesevelam and cholestyramine) to loperamide - can combining them help?

Getting the timing right: Why taking sequestrants at night on an empty stomach may be more effective than following cholesterol-lowering instructions.

Diet and lifestyle tips: How fatty meals can trigger symptoms and what you can do to reduce flare-ups.

Emerging treatments: A glimpse into GLP-1 receptor agonists like liraglutide and semaglutide, and their potential role in managing BAD.

Key Points

BAD affects more people than Crohn’s disease or ulcerative colitis - yet it remains underdiagnosed.
SeHCAT is the gold standard test, but blood tests like C4 may offer cheaper alternatives soon.
Don’t rely on loperamide (Imodium) without a formal diagnosis of BAD / BAM.

#14 Iron Deficiency and Anaemia: What Every IBD Patient Should Know

Tuesday, September 2, 2025 • Duration 39:55

Every IBD patient will have likely had a run-in with iron deficiency or anaemia at some point while living with ulcerative colitis or Crohn’s disease. And for many of us it’s a constant problem.

So in this episode of Wrestling the Octopus: The IBD Patient Podcast, Nigel and I wanted to invite an iron expert to join us and talk us through what inflammatory bowel disease patients need to know about managing iron deficiency and anaemia.

And who better to invite than the iron guru himself?! Professor Toby Richards, a London-based vascular surgeon and founder of The Iron Clinic explains how iron affects everything from energy and performance to recovery and mental health. We also chat about common dietary myths (Popeye got it wrong!), iron infusions vs tablets and the realities of living with Crohn’s disease or ulcerative colitis when you’re low in iron. Whether you're newly diagnosed or managing long-term IBD, this episode will help you understand your iron levels and explore treatment options that work.

What We Cover In This Episode

The difference between iron deficiency and anaemia
Why normal haemoglobin doesn’t rule out iron deficiency
How low ferritin affects energy, cognition and mental health
The surprising overlap between iron deficiency and ADHD-like symptoms
Why menstruating women with IBD face a “double whammy” of iron loss
The pros and cons of oral iron vs. intravenous iron infusions
What to expect before, during and after an iron infusion
How iron deficiency can mimic anxiety, fatigue and brain fog
Why IBD patients often “normalise the abnormal”—and how iron treatment can address this problem and restore quality of life

IBD & Iron

IBD patients face unique challenges when dealing with low iron: chronic blood loss, inflammation that blocks iron transport, and gut sensitivity that makes oral iron hard to tolerate. Professor Richards explains why iron levels are different for people with Crohn's and UC, and how personalised care can dramatically improve our quality of life.

#13 Nigel and Rachel Reflect on Recent Life with IBD...

Monday, August 25, 2025 • Duration 27:24

Welcome back, folks!

Think of this episode as a commercial break between our interviews with patients and healthcare professionals. In Episode 13, Nigel and I shoot the breeze about our lives with inflammatory bowel disease... with a little bit of insight into what it means to be a patient with either Crohn's disease or ulcerative colitis. We also swap notes on the annoying healthcare-related things we would like to consign to Room 101, given half the chance!

We hope you enjoy listening to our patient podcast on living with IBD. Please don't forget to spread the word if you're enjoying these podcasts - and do let us know if there's anything you'd like us to cover in future episodes. Thanks as always for your support!

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

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#12 Mental Health and IBD with Clinical Psychologist, Dr Stacey Boardman

Tuesday, August 12, 2025 • Duration 44:24

Ask anyone living with Crohn's disease or ulcerative colitis what their main concerns are and you'll find the topic of mental health in IBD right up there, top of the list.

So Nigel and I were delighted when we found out a mental health expert wanted to come onto our podcast to share a few pearls about supporting good mental health in IBD.

Welcome to Dr Stacey Boardman, an IBD clinical psychologist at Calderdale and Huddersfield NHS Foundation Trust. Stacey talks to us about her role on the gastro psychology team and how she supports IBD patients across a whole host of issues faced when living with inflammatory bowel disease.

As ever, we hope you enjoy this episode. And please do let us know of other topics you would like to see covered on Wresting the Octopus: The IBD Patient Podcast.

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

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#11 Author Vicky Ball Discusses Life With IBD - Plus Her Famous Viral Moment!

Thursday, August 7, 2025 • Duration 16:47

Author Vicky Ball has lived with mild inflammatory bowel disease since 2021.

She has published two teen fiction books, with a third adult fiction book in the works.

In this episode of Wrestling the Octopus: The IBD Patient Podcast, Vicky talks to us about how she manages her career as a writer while living with IBD. She also tells us about her now-famous viral moment with her book sales.

We hope Vicky's story spurs on many aspiring writers with IBD to achieve their publishing dreams!

You can follow Vicky on X at @vickyball3

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

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Wrestling the Octopus (IBD) – Details, episodes & analysis

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Wrestling the Octopus (IBD) – Details, episodes & analysis

Podcast details

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