@learningtim: sharing my journey. I was 67 ( I am female) when I had my first flare up and hospitalization. I was told I needed a colonoscopy within 3 months. I was So fortunate to have a gastro surgeon perform that because I was still sick and the doctor performing it immediately told me I was still quite inflamed. He also told me if I wanted to consider elective surgery to contact his office. I was terrified at the idea. I too thought I could keep it at bay with diet etc. I too journaled everything. What I ate, my pain, my bowel movements etc. I delayed any surgery decisions. Well fast forward and almost 3 years past the first episode. I continued to have flare ups. My surgeon was very clear that I could treat each flare up. And based on my disease he saw I had a 95% chance that I would have more. And diet changes would not going to help. He also said I could choose to just keep treating each episode. Ie antibiotics. Maybe hospitalizations etc. And surgery would be a quality of life decision. I was finding myself so sick on the antibiotics with each of the 6 flare ups over those 3 years and constant anxiety and fear I decided to have the surgery. ( also after trying hypnotherapy and a naturopath because I was still hoping to keep it at bay. But it didn’t work. I also asked him if this was his mother with this case like mine, what would he tell her? Without hesitation he said I would tell her to have the surgery! 😀 I am 3 months post surgery and have no regrets. Recovery was a bit longer / harder than I expected but I am really doing well now. So worth it. And I was lucky to get the amazing and kind surgeon that I got. It was done robotically and laparoscopic. I empathize with you. It is all terrifying. But if you can find a good surgeon who will take the time to review your case / condition of your disease, It will help dramatically on how you might proceed. Good luck