3-Step Treatment Roadmap
Toward Complete Remission
A systematic journey from symptom improvement to normalization of inflammatory markers and endoscopic recovery.
Treatment proceeds in three steps
Clinical
Remission
Normalization of
Inflammatory Markers
Endoscopic
Remission
Clinical Remission
Many people wonder if ulcerative colitis or Crohn's disease can truly be treated with Korean medicine, and how long the treatment will take. The overall treatment duration varies by patient. However, this does not mean treatment proceeds aimlessly without a clear goal.
At HanStep Korean Medicine Clinic, we aim for more than 50% improvement in initial symptoms within the 'first 3 months of treatment'. By accurately treating the primary root cause first, most patients see an improvement of over 50% within 3 months.
The total duration of treatment depends on the number of underlying causes the patient has.
When there is only 1 cause
As mentioned in the 'Classification of Korean Medical Causes' section, ulcerative colitis and Crohn's disease do not have a single cause. Occasionally, about 10% of patients have a single cause, in which case one prescription can complete the treatment from start to finish.
In such cases, treatment is easier, proceeds smoothly without aggravation during the process, and the patient feels more comfortable, leading to a shorter treatment period. If there is only 1 cause, treatment can be completed within 6-8 months, reaching endoscopic remission.
When there are 2 or more causes (Most patients)
This applies to patients who have two or more of the 6 causes: digestive type, inflammatory type, respiratory type, abdominal cold type, edema type, etc. In these cases, treatment is performed by eliminating causes one by one.
For example, consider a case with three overlapping causes: the digestive type with issues in the upper digestive tract, the inflammatory type where symptoms worsen after eating spicy food, and the respiratory type with high sensitivity to cold or rhinitis.
* The process where symptoms improve in steps as each cause is resolved
Treating the First Cause
Example: Treating the digestive type
If the most prominent cause is a digestive problem, we treat that first. As digestive treatment begins, symptoms like diarrhea, bloody stool, mucous stool, and abdominal pain start to decrease, leading to over 50% improvement within 2-3 months.
Temporary Aggravation and Prescription Change
Example: Appearance of a hidden second cause
Once the digestive problem is largely resolved, the second cause hidden behind the first one begins to surface, at which point symptoms worsen. Bloody stool may reappear, the frequency of diarrhea may increase, and the calprotectin level may rise. This temporary worsening after initial improvement is a necessary step in the treatment process. Diagnosis confirms that the digestive issue has not worsened as it was initially. At this stage, we appropriately adjust the prescription.
Sequential Prescription Changes and Clinical Remission
Example: Inflammatory type prescription, etc.
If a third cause appears after respiratory or rhinitis issues are treated, symptoms may worsen again. Since the remaining issue is likely inflammatory, we use the three types of prescriptions used for the inflammatory type in sequence to find the one that fits best, successfully eliminating bloody stool and diarrhea and normalizing inflammatory markers. As a result, we treat by changing prescriptions sequentially according to the causes. Since the number of causes is finite, improvement is inevitable.
Using the know-how accumulated by HanStep Korean Medicine Clinic since 2007, we achieve the first goal: Clinical Remission. Once clinical remission is achieved, the primary symptoms of ulcerative colitis and Crohn's disease—such as abdominal pain, diarrhea, bloody stool, and mucous stool—improve. Simultaneously, conditions like indigestion, heartburn, reflux esophagitis, hypersensitivity to cold food, rhinitis, and cold hands/feet also improve, leaving the patient in a state clinically equivalent to a healthy person.
Normalization of Inflammatory Markers
(Blood/Stool Tests)
All patients at HanStep Korean Medicine Clinic undergo examinations before starting treatment for ulcerative colitis and Crohn's disease. Blood test results from hospitals, as well as fecal calprotectin and fecal occult blood levels, are crucial.
Limitations of Blood Tests
- Test Items: CRP, ESR
- Why are they insufficient?
- Generally, if inflammation occurs only in the lining of the large or small intestine, it rarely affects the blood through the intestinal wall. Thus, even if there is significant inflammation on endoscopy, blood inflammation markers like CRP and ESR are often normal. If inflammation markers are normal at the beginning of blood tests, they often remain normal; therefore, blood inflammation markers are not critically important. If blood markers are abnormal, we monitor them throughout treatment to ensure they normalize.
Importance of Stool Tests
- Test Items: Fecal Calprotectin (FC), Stool Occult Blood (Stool OB)
- Key Indicators
- Since both ulcerative colitis and Crohn's disease involve inflammation in the intestine, checking fecal inflammatory markers is essential. Even in a state of clinical remission where there are no symptoms, fecal calprotectin and occult blood levels are often positive. If the calprotectin level is higher than the standard range, it indicates inflammation; a positive occult blood test indicates the presence of blood.
Final Goal of This Stage
Therefore, through complete treatment, we must ensure that both fecal calprotectin and occult blood levels return to normal.
This is the second treatment goal: normalization of inflammation markers. Once this stage is reached, we allow the patient to reduce and eventually discontinue western medication if they choose.
Endoscopic Remission
Once the second stage is achieved and all western medications are discontinued, we observe the patient while they take only Korean herbal medicine for 3 months.
This period is for completely stabilizing symptoms. We verify that symptoms do not recur after stopping western medication and that no other issues worsen the condition.
We conduct fecal inflammation tests every 4 weeks to confirm complete stabilization.
Once symptoms are confirmed to be stable for over 3 months without western medication, we recommend endoscopy, CT scans, and other examinations. We terminate the treatment only after confirming through these tests that the treatment results are positive.
Colonic Hypofunction Type Showing Special Progress
While 5 out of the 6 causes that worsen ulcerative colitis and Crohn's disease are of the diarrhea type, the 6th type, colonic hypofunction, is a constipation type and shows a different treatment progress.
Dosage Adjustment and Treatment Process
If judged as colonic hypofunction during initial treatment, medicine is prescribed to stimulate colon activity. Since the degree of hypofunction varies by patient, the dosage of Korean medicine must be consistently adjusted. We start with a low concentration and gradually increase the dosage. Once the optimal level is reached, bowel movements become easier, and bloody stool, diarrhea, abdominal pain, and bloating disappear.
Termination and Relapse Prevention
For colonic hypofunction, even after reaching clinical remission and normal inflammatory marker levels, one should not stop taking the medicine abruptly. If stopped suddenly, constipation may recur, leading to relapse after 10-12 months. Therefore, we must ensure constipation does not occur even without the medicine. By gradually tapering the dosage, we reach a point where constipation does not occur even after stopping, which prevents relapse. In the case of colonic hypofunction, the finishing period is often longer because we must ensure a tendency toward constipation does not reappear after complete remission.