Joe Manganiello has shared old hospital photographs showing the physical toll of an illness he largely kept private. The actor says he lost 60 pounds in the two weeks after emergency intestinal surgery in 2016.
The 49-year-old True Blood star posted the three images on October 15, two days after Avid Reader Press released his memoir, Bloodlines.
He included a content warning and presented the photographs as a visual companion to the book’s opening chapter. His numbered captions explain what each image records.
The illness affected far more than his digestive system. The memoir’s publisher describes problems involving his skin, thyroid, eyes and lungs during a seven-year search for answers.
The Photos Show His Hospital Stay and Later Treatment
* TRIGGER WARNING *
BLOODLINES • Chapter 1 • In pictures pic.twitter.com/UJq32O3i9W
JOE MANGANIELLO (@JoeManganiello) October 15, 2026
He pointed out the top of his ostomy bag above the sheets. Following the removal of his large intestine, the bag collected waste through a surgically created opening in his abdomen.
His second photograph shows his abdomen after a later operation. Manganiello described that procedure as a “reconnection/take down” surgery, or anastomosis, explaining that surgeons reconnected the remaining digestive tract so he no longer needed the bag.
The final image is a close-up of his face, marked by redness and irritation. He said it illustrated the numerous skin conditions he experienced, often simultaneously.
He Feared He Would Die Before Emergency Surgery
In an excerpt published by PEOPLE, Manganiello recalled being about two weeks into his hospitalization when severe pain and bleeding left him afraid he would not survive the night.
Surgeons operated the following morning. According to his account, they discovered his large intestine was dangerously damaged and close to rupturing. The ten-hour procedure left him uncertain whether he would need an ostomy permanently. He said doctors prescribed medications used for Crohn’s disease and colitis without resolving his symptoms.
He Spoke About His Illness in a June Video
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In a June 24 Instagram video announcing the memoir, Manganiello said only a small circle of relatives and friends had known what he was enduring.
He described spending months heavily medicated and undergoing procedures that sometimes left him unable to stand or walk. He also said he had spent three years writing the book.
He later told Entertainment Weekly that concealing the illness left him feeling unable to be himself in everyday conversations, including on set. Publishing his account offered a chance to stop hiding that part of his life.
Bloodlines follows his attempts to continue acting and directing through that period. Its scope also extends to family history, including his great-grandmother’s survival of the Armenian genocide, and his exploration of spirituality while searching for an explanation for his suffering.
Manganiello Says His Symptoms Have Subsided
In that October 13 interview, Manganiello said his symptoms had unexpectedly subsided more than three years earlier.
Although he never received a definitive diagnosis, he described himself as “healthy, happy, peaceful,” while acknowledging lasting effects from his procedures. Daily life, he said, had become manageable again.
Walking his dog now gives him time to notice things he appreciates: the smell of grass, wind moving through leaves and neighbors out with their own pets.
He Chose to Keep the Book’s Graphic Medical Details
Manganiello told the magazine that his editor had questioned whether he wanted to retain some of the graphic descriptions. He kept them because he wanted readers to understand the suffering behind his recovery.
Recording the audiobook presented another challenge. Reading painful passages aloud made him feel as though he had returned to those experiences. He described the process as difficult rather than therapeutic. The unabridged audiobook, narrated by Manganiello himself, runs eight hours and 42 minutes.