Joe Manganiello says Sofía Vergara authorized an operation that saved his life during their marriage. The 49-year-old actor revisits that period in his upcoming memoir, Bloodlines.
Manganiello also alleges that Vergara refused to hug him when he pleaded for affection during his illness. He writes that their marriage had “become devoid of any emotionality whatsoever,” according to an October 7 report from PEOPLE.
Manganiello and Vergara married in November 2015 and announced their separation in July 2023. Their divorce was finalized in April 2024.
Bloodlines is scheduled for release October 13 through Avid Reader Press/Simon & Schuster. Vergara had not publicly addressed the new allegations when Us Weekly reported them on October 7 and said it had contacted her for comment.
He Spent Seven Years Ill Without a Conclusive Diagnosis
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Manganiello says his symptoms began shortly after the wedding. Abdominal pain sometimes left him unable to walk, while digestive ulcers, fevers, blistering rashes, bleeding and exhaustion became recurring problems.
Across the seven-year ordeal, he lost 60 pounds and underwent numerous colonoscopies. Doctors tried medications used for Crohn’s disease and colitis, but he says he never received a conclusive diagnosis or found lasting relief from those treatments.
After 13 years of sobriety, he questioned whether he could still describe himself as sober while using hydrocodone pills and fentanyl patches for pain.
Vergara Authorized the Operation While He Was Unconscious
In an authorized memoir excerpt published by PEOPLE, Manganiello recalls a 2016 hospitalization during which tests failed to explain his worsening pain and bleeding. Vergara was sleeping on a cot in his room.
After a particularly severe night, doctors proceeded with emergency exploratory surgery. He writes that his entire large intestine was badly infected and close to rupturing, and that a rupture would have killed him through sepsis.
With Manganiello under anesthesia, the medical team contacted Vergara as his next of kin. She approved removing his large intestine and creating an opening in his abdomen so his small intestine could empty into an ostomy bag.
He describes her choice as a “brutal but lifesaving decision.” The operation lasted roughly 10 hours. When he woke, Vergara was at the foot of his bed, explaining the procedure and the possibility that he would need the ostomy indefinitely.
Caring for Bubbles Changed His Focus
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Manganiello says he adopted Bubbles, a sick Chihuahua, in 2019 while experiencing suicidal thoughts. Looking after the dog gave him someone else’s needs to consider during a period dominated by his own pain.
“I went from being the patient to the caretaker,” he told PEOPLE. He also alleges that Vergara ridiculed his attachment to Bubbles.
He Says Fear of Dying Changed His Plans for Children
Vergara offered her explanation for the divorce in a January 2024 interview with El País. She said Manganiello wanted children and she did not want to become an older mother.
He disputed that explanation in a July 2024 Men’s Journal interview. Manganiello acknowledged wanting a family and said they had tried to conceive during their first year and a half together. He maintained that he had promised not to leave if their attempts failed and attributed the breakup to their growing apart.
He now says they considered an egg donor after unsuccessful IVF attempts. He became afraid he would die and leave Vergara raising a child who was not biologically hers, and says that fear led him to abandon fatherhood during their marriage.
He Credits an Unconventional Search With Helping His Recovery
Manganiello’s search for relief eventually took him to a medicine man in Cuba and a shaman in Santa Monica. He believes confronting trauma in his family’s history, including his great-grandmother’s survival of the Armenian genocide after losing nine children, contributed to his recovery.
Dr. Dawn Beaulieu, a Vanderbilt University Medical Center gastroenterologist who has not treated Manganiello, told PEOPLE that autoimmune diseases can enter remission and that the available information establishes only that he has improved.
He also underwent follow-up surgery to reconnect his digestive tract. He now says he is symptom-free and no longer takes medication for the illness.
He Is Open to Having Children Again
Manganiello and actress Caitlin O’Connor became engaged in June 2025 and announced the news that October with a photograph featuring Bubbles, according to Good Morning America.
By December, O’Connor had confirmed to PEOPLE that they had left Los Angeles and settled in Mount Lebanon, Pennsylvania, where Manganiello grew up. Asked about having children now, Manganiello told PEOPLE he remained open to it: “If that’s meant for me.”