If you are in Dubai, Toronto, Lagos, Manchester or Melbourne, the thing standing between you and starting treatment usually is not doubt about the medicine. It is a logistical picture in your head: flights, a clinic in another country, weeks away from work, a body that cannot reliably survive a long-haul journey in the first place.
Delete that picture. It does not apply here.
There is no procedure, no in-clinic therapy and no clinic visit at any stage. Not to begin, not during, not at the end. The EPOH protocol is entirely formulation-based — oral compounds and topical preparations, compounded to you, couriered to you, taken at home. There is nothing in it that requires you to be in a room with us.
This article explains, step by step, what actually happens.
Before the call
We ask you to send what you already have, ahead of time, over WhatsApp or email. The point is for the doctor to have read your file before the consultation rather than during it.
Useful to send:
- Scoping and biopsy reports — colonoscopy, endoscopy, histopathology.
- Imaging — MR enterography, CT enterography, ultrasound.
- Recent bloods — CRP, ESR, full blood count, ferritin and iron studies, albumin, B12, vitamin D, and faecal calprotectin if you can get it.
- Current prescriptions, with doses.
- Surgical history — any resection, stricturoplasty, abscess drainage, seton.
- A rough symptom diary — even two weeks of it is worth more than a memory.
If you do not have all of this, come anyway. We work with what exists and tell you what is worth adding.
The consultation itself
It is a video call, and it is a clinical consultation, not a sales call. It is unhurried, because the profile we build in it determines what gets compounded for you. Six things get covered.
1. History
The full picture, not only the gut. When your symptoms began, what your life looked like at the time, what else you carry — joint pain, skin involvement, mouth ulcers, eye inflammation, anaemia, thyroid disease, anxiety, disrupted sleep. Crohn's rarely travels alone, and its companions tell us which mechanism is driving it.
2. Disease course
The shape of your disease over time. Age at onset. Where it sits in the bowel. Whether it has been steadily grumbling or violently episodic. Hospitalisations. Steroid courses. Surgeries. What a typical flare looks like for you, how long it lasts, and what ends it.
A disease that has escalated in a stepwise way over eight years is a different clinical object from one that appeared eighteen months ago and has never settled.
3. Prior treatments, and how each one ended
Mesalamine, steroids, immunomodulators, biologics. For each: did it work, for how long, why did it stop, and what did it cost you in side effects?
This matters more than people expect. A biologic that lost response after two years tells us something quite different from one you never tolerated. Secondary loss of response, steroid dependence and repeated post-surgical recurrence each point at different drivers.
4. Current medication
We go through everything you are taking now, with doses — and then we say the sentence that surprises most people:
Keep taking all of it.
Treatment with us begins alongside your existing medication. We do not ask you to stop, reduce, skip or taper anything to start. If reduction becomes appropriate later — usually once flares are less severe and your markers agree — it happens gradually, and with the physician who prescribed the drug. That decision is theirs and yours, not ours alone.
5. Symptom pattern
The granular, undignified detail. Stool frequency and form. Urgency versus frequency (they are not the same problem). Night-time symptoms. Blood. Where the pain sits and when it comes relative to eating. Perianal symptoms — we will ask, and we would ask you to answer plainly; there is nothing here we have not heard. Fatigue. Weight trajectory. Appetite. Sleep.
And the pattern around the symptoms: what do your flares track with? Stress? Travel? A course of antibiotics? Your menstrual cycle? A specific category of food? Nothing you can name at all?
6. Driver-profile assessment
This is the part that is unfamiliar to most patients, and it is the part that determines your compound.
We assess five drivers — gut, immune, metabolic, hormonal, and stress/cortisol — and how loudly each is contributing in your particular case. That is why we ask about your job, your sleep, your stress load, your weight history and your cycle, when you came expecting to be asked only about your bowel.
Two people with near-identical scope findings can be running on entirely different engines. They do not get the same formulation.
What we tell you on the call
We tell you what we think is achievable, including when the answer is uncomfortable. If you have advanced structural change — established fibrotic stricturing, extensive damage, resected bowel — full remission may not be on the table, and we say so on the call, before you spend anything, not after.
After the call: compounding and courier
Your formulations are then compounded to your profile and the phase you are starting in — oral Inflammatory Load Reduction compounds for Phase L, and later the Phase I, Phase F, Phase E and Phase S categories as your treatment moves through them.
They are couriered to your address. Domestically across India, and internationally with the documentation the destination requires. You receive a schedule with them: what to take, when, in relation to meals, and how it sits around the medication you are already on.
Follow-ups
Follow-ups run by video or WhatsApp. Video at phase transitions and whenever something needs a proper look; WhatsApp in between, for the things that do not need a scheduled appointment.
Message us when a flare starts, when something changes, when a marker comes back, and — importantly — when you hit the Partial Improvement Plateau somewhere around weeks three to six, feel like it has stopped working, and want to quit. That message is not an imposition. It is the one we most want to receive, because that plateau is usually the signal that your next phase should begin.
What a remote consultation cannot do, honestly
It cannot scope you or take a biopsy. We rely on your gastroenterologist's investigations, and we will ask you to keep them current rather than let them go stale.
It is also not an emergency service. Obstruction, severe bleeding, high fever, a suspected abscess, uncontrolled vomiting — that is a hospital, immediately, and we will tell you so without hesitation.
Within those limits, remote care works because inflammatory bowel disease is followed by markers and symptom pattern — and both of those travel perfectly well down a video call and a courier route.
This is not a compromised version of the treatment
It is worth being blunt: remote delivery is not a watered-down substitute for something better that happens in a building. There is no procedure being withheld from you. The protocol is formulation-based by design, which is precisely why geography stops mattering.
Your next step
Book a video consultation. Send your reports beforehand. Bring your current prescriptions and your questions.
Formulations are compounded to your driver profile and couriered to your door, in India or anywhere internationally. Follow-ups happen by video or WhatsApp.
There is no procedure, no in-clinic therapy and no clinic visit at any stage.
