This story represents a composite of common IBD experiences and is presented to help readers feel less alone in their journey.

The Morning That Changed Everything

I was twenty-four and three months into my dream job at a marketing agency when I found myself hiding in the office bathroom for the third time that morning. My hands shook as I checked my watch—9:47 AM. The client presentation I’d been preparing for weeks was scheduled to start in thirteen minutes, and I was supposed to be leading it.

The cramping had started during my commute, that familiar twist in my lower abdomen that I’d been dismissing for months as “stress” or “bad coffee.” But this morning was different. This morning, I couldn’t pretend anymore that something wasn’t seriously wrong.

I splashed cold water on my face and practiced my opening line in the mirror: “Good morning, everyone. Thank you for joining us today to discuss your Q4 campaign strategy.” My reflection looked pale and tired, but I forced a smile. I had worked too hard to get here to let whatever this was derail my career before it even started.

The Beginning: When Normal Stopped Being Normal

Looking back, the signs had been building for months. It started during my final semester of college—urgent bathroom trips that I blamed on senior year stress and too much campus dining hall food. The blood I noticed occasionally? Probably just hemorrhoids from sitting too much while writing my thesis. The fatigue that made me want to nap between classes? Normal for a busy student juggling internship applications and final projects.

Even when I landed my first job at Morrison & Associates, a mid-sized agency known for its fast-paced environment and demanding clients, I convinced myself that my increasing bathroom urgency was just new-job anxiety. Everyone told me the first year of professional life was an adjustment. I figured the constant low-grade exhaustion and the way my stomach seemed to revolt against the free office snacks were just part of growing up.

The diagnosis came three weeks after that disastrous presentation—the one where I had to excuse myself twice and came back looking so pale that my boss, Sarah, pulled me aside afterward to ask if I was okay. I’d finally made an appointment with a gastroenterologist after my primary care doctor ran some blood tests that showed elevated inflammatory markers.

“Ulcerative colitis,” Dr. Martinez said, pointing to images on his computer screen that looked like an angry, inflamed landscape. “It’s an inflammatory bowel disease that affects the colon and rectum. The good news is that it’s very treatable, and many people with UC live completely normal, active lives.”

I nodded and smiled and asked all the right questions, but inside I was screaming. Normal? How was having a chronic disease that attacked my digestive system normal? How was I supposed to build a career when I couldn’t predict when my own body would betray me?

The Struggle: Learning to Navigate Professional Life with an Invisible Illness

The first few months after my diagnosis were a masterclass in imposter syndrome with a twist. Not only did I feel like I didn’t belong in the professional world as a recent graduate, but now I was also trying to figure out how to manage a chronic illness that seemed determined to sabotage every important moment.

I became an expert at bathroom mapping—knowing the location of every restroom on every floor of our office building, memorizing the layouts of client offices before meetings, and always choosing the aisle seat in conference rooms. I kept a small bag in my desk drawer with spare underwear, wet wipes, and the emergency medications Dr. Martinez had prescribed for flare-ups.

The fatigue was perhaps the hardest part to hide. While my colleagues stayed late brainstorming creative campaigns or grabbed drinks after work to network, I found myself declining more often than I wanted to. The medications I was trying—first mesalamine, then a brief stint with prednisone that made me feel simultaneously wired and exhausted—affected my energy levels in unpredictable ways.

There were victories and setbacks. I successfully managed a product launch campaign for a major client, working around two mild flares by carefully timing my medication and keeping crackers in my desk for when my stomach felt too unsettled for regular meals. But I also had to miss a company retreat to the mountains when a severe flare landed me in urgent care, and I watched from my hospital bed as my teammates posted photos from team-building activities I’d been looking forward to for months.

The worst part wasn’t the physical symptoms—it was the constant mental calculation. Should I speak up in this meeting even though I might need to leave suddenly? Could I commit to leading this project knowing that UC flares were unpredictable? Was it fair to my team if I couldn’t always be at 100%?

I started declining opportunities I wanted, turning down stretch assignments and leadership roles because I was terrified of letting people down. I convinced myself I was being responsible, but really, I was letting fear make my career decisions for me.

The Turning Point: Finding My Advocate

The shift began during a particularly challenging week about eight months after my diagnosis. I was managing a tight deadline for a client campaign while dealing with a moderate flare that had me running to the bathroom every hour. I’d been trying to power through, fueled by determination and probably too much coffee, when Sarah knocked on my office door.

“Can we chat?” she asked, and my heart sank. I was sure she’d noticed my frequent absences from my desk and was going to have “a conversation” about my performance.

Instead, she closed the door and said, “I don’t know what you’re dealing with, and you don’t have to tell me if you’re not comfortable. But I can see that you’re struggling, and I want you to know that you’re not alone. I’ve been managing type 1 diabetes for fifteen years, and I learned the hard way that trying to hide a chronic condition at work usually backfires.”

I stared at her, completely caught off guard. Sarah, who seemed to effortlessly juggle multiple high-stakes clients and never missed a beat in presentations, had her own invisible health challenge?

“I have ulcerative colitis,” I found myself saying, the words tumbling out before I could stop them. “I was diagnosed a few months ago, and I’m still figuring out how to manage it. I’m worried it’s affecting my work, and I don’t want anyone to think I can’t handle my responsibilities.”

What followed was the most honest conversation about chronic illness and career ambitions I’d ever had. Sarah shared her own journey of learning to advocate for herself professionally while managing diabetes, including the accommodations she’d negotiated and the mindset shifts that had helped her thrive rather than just survive.

“Your illness doesn’t define your capabilities,” she told me. “But pretending it doesn’t exist isn’t helping you or the team. Let’s figure out how to set you up for success.”

Living Well Today: Redefining Professional Success

Two years later, I’m still at Morrison & Associates, but my relationship with both my career and my UC has transformed completely. I’m now a senior account manager, leading campaigns for some of our biggest clients, and I haven’t let ulcerative colitis hold me back from a single opportunity I truly wanted to pursue.

The practical changes made a huge difference. I worked with HR to establish some basic accommodations—flexible work-from-home options during flares, the ability to take breaks as needed during long meetings, and access to a private office space when necessary. These weren’t dramatic changes, but they gave me the security to focus on my work rather than constantly worrying about managing symptoms.

More importantly, I learned to reframe what professional confidence actually means. I used to think it meant never showing weakness, never admitting when something was difficult, and always being “on.” Now I understand that real confidence comes from knowing your worth, advocating for your needs, and showing up authentically—even when that includes acknowledging that you’re managing a chronic illness.

I’ve become the team member who speaks up about realistic timeline expectations, who suggests building buffer time into project schedules, and who advocates for sustainable work practices that benefit everyone. Ironically, managing UC has made me a better colleague and leader because it taught me to think systematically about challenges and solutions.

My current treatment plan—a combination of mesalamine maintenance therapy and lifestyle modifications including stress management and dietary awareness—keeps me in remission most of the time. When flares do happen, I have a clear action plan that includes communicating with my team, adjusting my schedule as needed, and focusing on recovery without guilt.

A Message of Hope: You Are More Than Your Diagnosis

If you’re reading this while struggling to balance career ambitions with IBD management, I want you to know that your dreams don’t have to shrink to accommodate your diagnosis. Yes, you might need to approach things differently than you originally planned. Yes, there will be days when UC feels like it’s calling the shots. But your condition is just one factor in your professional life—it’s not the defining factor.

The skills that chronic illness teaches you—resilience, problem-solving, self-advocacy, empathy, and strategic thinking—are exactly the skills that make great employees and leaders. You’re not broken or less capable because you have IBD. You’re someone who has learned to navigate complex challenges while pursuing your goals, and that’s actually a superpower in the professional world.

Find your Sarah—the mentor, colleague, or friend who can help you see that managing a chronic illness while building a career isn’t about perfection, it’s about persistence and self-compassion. Join online communities, connect with other professionals who understand the unique challenges of working with IBD, and remember that asking for help or accommodations isn’t a sign of weakness—it’s a sign of wisdom.

Your career journey might look different than you originally imagined, but different doesn’t mean diminished. Some of my proudest professional moments have happened not despite having ulcerative colitis, but because managing it taught me skills and perspectives that made me better at my job. Your story is still being written, and it’s going to be remarkable.