Working With Crohn's or Colitis: Why the Email to Your Manager Stays Unsent

It's Sunday evening. There's a draft email to your manager sitting in your work inbox. It's short. It asks if you could start an hour later on bad mornings, and whether you could sit a little nearer the toilets. You wrote it three weeks ago. You've opened it a dozen times since. You haven't sent it.

Instead, you've kept going the old way. Leaving the house at six so the commute is quieter. Sitting at the end of the row in meetings so you can slip out. Saying "just a stomach bug" when you miss a morning. And every Sunday evening, your gut tightens a little before the week has even started.

If you live with Crohn's disease or ulcerative colitis, you may have searched "working with Crohn's" hoping for a list of tips. This post is about the part underneath the tips: why telling people at work can feel so hard, what carrying the secret can do to your body, and how to make work feel a little safer.

Why the Email Feels So Heavy

The email itself is only a few lines. What makes it heavy is everything your mind attaches to it. Will they think I can't do the job? Will it come up when promotions are decided? Will people talk about my bowels?

That fear has real roots. Crohn's & Colitis UK lists the stigma associated with a condition like Crohn’s or Colitis as one of the main things that trigger anxiety and depression for people living with it, along with dealing with unpredictable and invisible symptoms. The same guide says certain symptoms can make you feel worried or ashamed about what others think of you, and that this can be hard for others to understand when your symptoms are not visible.

Work is where those two things meet. Your colleagues see you looking fine at your desk. They don't see the planning that got you there. So the condition stays invisible, and the more invisible it is, the harder it feels to suddenly name it.

There's often an older story in it too. Maybe you were once teased for leaving class. Maybe a past boss sighed when you called in sick. The mind remembers those moments and quietly uses them to predict how this one will go.

What Hiding It Can Do to Your Gut

Keeping a secret at work isn't a one-off effort. It's a low hum that runs all day: watching the clock, mapping the toilets, rehearsing excuses. That hum is stress, and stress doesn't stay in your head.

Crohn's & Colitis UK describes the gut-brain axis as a direct two-way link between the gut and the brain. It says there’s some evidence that stress might make your Crohn’s or Colitis symptoms worse and increase the risk of a flare-up, and that people who have both mental health problems and Crohn’s or Colitis can end up in a cycle, with each one making the other worse. A 2022 systematic review of 38 studies with 4,757 people with IBD found that psychological stress appears to come before IBD flares, though the authors say it is still unclear how stress is best managed.

Please read that carefully. It doesn't mean your job caused your Crohn's or colitis, and it doesn't mean one hard week will start a flare. It means the strain of hiding is part of the picture, alongside your treatment. And it's a part you can do something about.

There's also a trap in the moment itself. Stress has body effects of its own, and the guide notes that some symptoms, like diarrhoea and fatigue can be like those of Crohn’s or Colitis. So you feel a churn before the Monday meeting, your mind reads it as a flare starting, and the worry makes the churn stronger.

The Quiet Cost of Pretending You're Fine

Hiding also takes energy you don't have spare. Crohn's & Colitis UK lists living with ongoing invisible symptoms such as fatigue or pain as one of the times when your mental health is more likely to suffer.

So you do a full day's work, plus a second invisible job of managing how it looks. By Thursday you're running on empty. That's not weakness. It's two jobs at once.

What Can Help, Starting With the Mind

The fear grew one awkward moment at a time. It can ease the same way, one small step at a time.

• Tell one person first. It doesn't have to be your manager. A colleague you trust is enough to start. Talking can also help family, friends or colleagues to understand what you’re going through. One person who knows can cover for you in a meeting without a single question.
• Get help with the words. Crohn's & Colitis UK has a Talking Toolkit, and says that if you want to tell people about your condition, the toolkit can help. The charity's information also covers concerns about relationships and employment. Keep your message simple: what you have, what helps, what you're asking for.
• Calm your body before the hard moments. Relaxation techniques may help to reduce anxiety, pain and stress levels and improve your mood if you have Crohn's or colitis. A few minutes of slow breathing, with the breath out longer than the breath in, is an easy start. Try it on the commute, and before you open that draft email.
• Notice when your mind is living in an old workplace. Mindfulness is about noticing when we are stuck in patterns of worrying about the past or future, and the guide says it can be helpful for Crohn’s and Colitis, as a way of developing skills for managing stress. When the old boss's sigh replays in your head, name it: "That was then." Then look at the person actually in front of you.
• Make the week smaller. The guide suggests that some people find it helps to set smaller goals or ‘micro-tasks’, and to accept that you might have to change plans at times – and don’t feel guilty about it. A day where you get through the three things that matter is a good day.
• Ask about talking therapy. CBT aims to help you explore and change unhelpful patterns of thinking and behaviour. There is evidence that people with Crohn's or colitis who get psychological support have lower stress levels and are more able to cope with symptoms, though the guide is honest that more evidence is needed to say whether psychological therapies can also improve gut symptoms. In the UK, it says the team should include access to a psychologist or counsellor, so it's fair to ask.

Working on the worry is worth it for your gut, too. Crohn's & Colitis UK says finding ways to manage your anxiety can reduce your chances of having a flare-up and needing steroid treatment.

Your Treatment Is Part of Your Working Life

Lunch choices, sleep and a steady routine still matter. They just work best as support for a calmer mind, not as rules written by fear. If work is hard to manage, tell your IBD team. It's part of how your condition is going, not a side issue.

Your treatment helps your mind as well as your gut. Crohn's & Colitis UK says keeping gut inflammation under control may help to improve your mental health, and that your Crohn's or colitis medicines can help with this. It also warns that not sticking to your usual treatments can lead to more frequent flare-ups. Any change to your medication is a decision to make with your IBD team, never alone.

The Email, Sent

Imagine Daniel, who has had Crohn's for eight years and works in a busy accounts team. For a long time, he told no one at work. He took his sick days as "migraines", ate nothing before noon on meeting days, and spent Sunday evenings dreading the week.

What changed wasn't one brave speech. He told his IBD nurse how much work was weighing on him, and she pointed him towards talking therapy. He told one colleague first, over coffee. A month later, he sent the email: three lines, no apology. His manager replied the same afternoon and asked what else would help. Some weeks were still hard. But the Sunday dread started later, and some weeks it didn't come at all.

His Crohn's didn't go away. But he stopped doing two jobs at once. And as Crohn's & Colitis UK reminds readers, your life is not just about your Crohn’s or Colitis.

Not every manager will answer like Daniel's did. But hiding has a cost too, and you've been paying it quietly. The draft is still sitting there. You don't have to send it tonight. You can start with one person, one breath, one smaller week. Feeling much calmer at work is possible.

Who is one person at work you could tell first, and what would you want them to know?