The classification your gastroenterologist already uses
This is not a staging system we invented. It is the one on your clinic letter, and it is the single biggest determinant of what root-cause correction can realistically achieve for you.
Inflammatory — the most reversible
Active inflammation without stricture or fistula. The tissue is inflamed, not yet structurally changed.
This responds most completely. Inflammation is a process, and processes can be stopped and reversed.
Stricturing — partly reversible, and the distinction is everything
Narrowing of the bowel. The critical question is what the narrowing is made of:
- an inflammatory stricture can soften as the inflammation resolves;
- a fibrotic stricture is scar, and it will not.
Scar does not reverse with any internal treatment — ours included. Distinguishing the two decides what is achievable, and it is the first thing we assess.
Obstruction is an emergency. Severe cramping, vomiting, no passage of stool or gas — that is hospital, now.
Penetrating — complex, and response varies most widely
Fistulas, abscesses, tunnelling through the bowel wall. Established fistulising disease is the most complex presentation. We will tell you honestly where you sit before you commit to anything.
An abscess needs drainage. Now. Not a consultation with us.
Recovery Stages — treatment response
Do not confuse these with disease behaviour above. They measure different things.
| Recovery Stage | Timeline | What you experience |
|---|
| 1 — Internal Shift | Weeks 1–4 | Digestion, sleep, energy improve. Stool frequency may not have changed yet. This IS progress. |
| 2 — Reduced Frequency | Months 2–4 | Flares less frequent, shorter, resolving more completely. The disease itself starts to change here. |
| 3 — Reduced Severity | Months 4–8 | Same provocations, diminished response. Medication-reduction conversations become appropriate. |
| 4 — Stable Remission | Months 8+ | Extended periods without active disease. Monitoring replaces management. |
The Partial Improvement Plateau — weeks 3 to 6
Around week three, many patients improve a little and then stop. It feels like the treatment has stalled, or worked briefly and is now failing.
It is not failure. It is the signal that Phase 1 has done its work and Phase 2 should begin.
We tell you now, before you start, because this is the point at which patients quit something that is working.
Honest candidacy
Patients with established fibrotic stricturing, extensive prior resection, or severe penetrating disease may not achieve full remission. For them the realistic goal is a lower inflammatory burden and a lower medication load — which is worth having, and which is not the same thing as remission.
Bowel that has been resected does not grow back. Scar does not un-form. We would rather tell you that before you pay us than after.
