Most clinics answer the question "will this work for me?" with a version of "yes". We would rather turn away a patient we cannot help than take their money, so this page answers it properly, including the parts that lose us the enquiry.
Read the first section before anything else.
If this is an emergency, we are not the answer — and not "later" either
If you are in an acute severe flare, if you have signs of bowel obstruction (persistent vomiting, absolute constipation, a distended and increasingly painful abdomen), or if you have any sign of perforation (sudden severe pain, a rigid abdomen, fever, collapse) — go to an emergency department now.
Not after a consultation with us. Not after finishing a course of anything. Not "once this settles". These are surgical emergencies and they are measured in hours.
We do not take these patients, we do not ask them to wait, and we do not start any oral protocol during an unresolved acute severe flare. Anyone who offers to treat that at a distance is putting their business ahead of your bowel.
Who responds well
Response to EPOH tracks with how much of the bowel is still capable of repair — not with how long you have suffered, not with how motivated you are, and not with how much you want it to work.
Inflammatory disease — non-stricturing, non-penetrating. This is the phenotype the protocol is built for. The problem is active inflammation in tissue that is still structurally intact. Inflammation is a process, and processes can change direction. This is where we expect the most from Phase L and Phase I.
Shorter disease duration. The less time the bowel wall has spent inflamed, the less permanent architectural change it has accumulated. Someone two years in generally has more repair capacity to work with than someone twenty years in — even if today they feel equally unwell.
Preserved biological repair capacity. Adequate nutritional status, reasonable absorption, no severe uncorrected deficiency, no advanced structural loss. The protocol supplies conditions for repair; it does not supply the repair itself. The body does that, and it has to be in a position to.
Patients who begin while still on their current medication. This is one of the strongest predictors we see, and the one patients most often get wrong. Starting our protocol on top of existing treatment, with the prescribing doctor still monitoring, gives us a stable floor to work from. Starting it after having stopped medication means we are trying to lower inflammatory load in a system that is simultaneously rebounding — and we cannot tell which of the two forces is producing what we observe. We never ask anyone to stop medication. We ask them not to.
A clear identifiable driver profile. Cases where the pattern is legible — a recognisable relationship to diet, sleep, stress load, prior antibiotic exposure, a definable inflammatory pattern — respond better than cases where nothing correlates with anything. A protocol that is aimed at something works better than one that is aimed at everything.
Who responds partially, or not at all
This is the section that matters. Say it plainly, before payment, not after.
Established fibrotic strictures. A stricture that is scar tissue is not reversible by any internal treatment — not ours, not a biologic, not anything taken by mouth. Scar is scar. It does not soften because the inflammation around it has been reduced. If your narrowing is fibrotic, the honest position is that our protocol cannot open it, and a strictured segment carries an ongoing obstruction risk that is a surgical and gastroenterological matter. Some strictures are inflammatory rather than fibrotic, and those can behave differently — but that distinction is made by imaging and by your consultant, not by us, and not by hope.
Extensive prior resection. Removed bowel does not grow back. If a substantial length has been resected, the resulting absorption and transit problems are anatomical. They are not an inflammatory load that can be lowered. We may still be able to help with inflammation in the bowel that remains — but we will not pretend that treating inflammation restores length that is gone.
Severe penetrating or fistulising disease. Fistulae and abscesses are structural complications requiring surgical and specialist medical care. This is not a phenotype where an oral protocol delivered at a distance is the right primary answer, and we will say so.
Long-standing disease with advanced structural change. Decades of disease, extensive architectural damage, repeated surgeries. Repair capacity here is limited by what is physically left.
For these patients the realistic goal is not remission. It may be a reduction in inflammatory burden and a reduction in medication load — which, for someone who has been on repeated steroid courses for years, is not a small thing. But it is a different thing, and we will name it as a different thing at the consultation, in writing, before you pay us. If that is the honest ceiling of what we can offer you, you deserve to hear it while you still have the option of not starting.
The word we will not use
We do not say cure, and we will not. Crohn's is not cured — not by us, not by any medication currently in existence. What can change is inflammatory burden, symptom frequency and severity, and how much medication is needed to hold the position. Anyone using the word cure in this condition is either uninformed or selling something.
What honest candidacy actually looks like in practice
At the consultation we are trying to answer three questions:
- Is this an emergency? If yes, you go to hospital and we stop.
- Is the problem inflammatory, or is it structural? Inflammation is our territory. Structure — scar, resection, fistula, obstruction — largely is not.
- Is there enough repair capacity left for the goal you are hoping for? If not, we tell you what the smaller, real goal is, and you decide whether that is worth your money.
If the answer is that we cannot meaningfully help you, we say so and we do not enrol you. That is not modesty. A patient who was sold remission and got a partial reduction in medication load is a patient we failed, even if the medication load genuinely fell — because we told them the wrong thing.
If you do proceed
The protocol runs oral formulations in sequence: Lowering the Load (Phase L) first, then Internal Healing (Phase I), with Functional Clearance (Phase F) running largely alongside Phase I, and Sustaining Remission (Phase S) tapered at the end. Phase F is never brought forward — mobilising load before Phase L and Phase I are stable pushes more into a system than it can clear, and in Crohn's that means a worse bowel, not a faster result.
Throughout it, you stay on your prescribed medication unless your own doctor changes it, and you stay under gastroenterology monitoring — bloods, calprotectin, scans, scopes. We will not ask you to stop being watched.
Next step
Candidacy is decided in a video or WhatsApp consultation, not by a form. Bring your recent reports — imaging, endoscopy, calprotectin, bloods — because the distinction between inflammatory and fibrotic disease is the distinction that decides whether we can help you at all.
If we can, formulations are couriered to you. There is no procedure, no in-clinic therapy, and no clinic visit at any stage. If we cannot, we will tell you that instead, and you will not have paid us to find out.
