Gastroenterology · Boao Lecheng cluster
Crohn's disease and ulcerative colitis: treatment in China, Hainan
Every attempt to come off steroids ends with the flare returning, and the biologic holds for a shorter stretch each time. What takes six months of queues at home is assembled in the Hainan cluster in days: endoscopy with the histology re-read, intestinal ultrasound, calprotectin, drug levels, a rebuilt regimen. Honestly, up front: there is no cellular programme here for Crohn's disease or ulcerative colitis — this is diagnosis and revision of treatment. The first step is free: Dr Yang reads your records and answers in writing whether there is any point in flying. "You do not need to come" is an answer too.
About the condition
Before you think about travelling
Bloody stool six or more times a day, with fever, a racing pulse or anaemia — that is a severe attack, settled in the nearest hospital, not by a trip. In Crohn's disease the warning signs differ: cramping pain with distension and no stool or gas passing, fever with chills from a fistula, heavy bleeding. Severity thresholds, and which drugs turn dangerous in an attack, are in the long read.
Crohn's disease and ulcerative colitis are two different diseases inside the group called inflammatory bowel disease (IBD). In remission, or at low activity, everything below is for you. Time works against you quietly: years of "maintenance" mesalazine in Crohn's disease, steroid dependence with no review of the regimen, a fistula under a seton with no systemic therapy — none of it hurts more sharply, but it takes the bowel away piece by piece. Whether coming makes sense is visible from your records.
Why people come
The situations we see most often
If one of these is yours, it is worth establishing the stage and the options.
- The steroids will not let go
Every attempt to reduce prednisolone brings the flare back, and this is not the first round.
- The biologic has stopped working
There was a response, then it faded — and drug levels and antibodies were never measured.
- A fistula that will not close
The seton has been in for months, the discharge continues. The trip covers pelvic MRI, anti-TNF levels and an answer on removing it.
- Treatment by how you feel
No targets: calprotectin unchecked, the colonoscopy long ago, doses adjusted by eye.
- Surgery is being discussed
Resection or colectomy is on the table, while the histology deciding it is read differently by different people.
- It feels as though the options have run out
The classes available at home are worked through, and you want to know if anything else exists.
Standard care first
What is normally done before anything else
We do not propose replacing proven treatment. On the contrary: without it, any next step loses its meaning.
Standard therapy comes first, and most questions are settled at that level. Check your own treatment against the list — with your physician, not instead of one:
- Stopping smoking in Crohn's disease — it roughly doubles the risk of post-operative recurrence. The one item here that depends on you alone
- Mesalazine — the foundation in ulcerative colitis, including suppositories, foam and enemas: the topical form often beats tablets. In Crohn's disease ECCO, ACG and BSG do not recommend it; Russian guidelines still allow it in mild disease — a divergence of standards, not an error by your physician
- Steroids only to break a flare, as a short course. They are not used to maintain remission: if you cannot manage without them, that is an indication to change treatment, not to extend the course
- Choose a class, not a brand — thiopurines, anti-TNF, the newer biologic classes, small molecules. Before anti-TNF, exclude latent tuberculosis and hepatitis B; before thiopurines, check the TPMT and NUDT15 genes
- Before escalating immunosuppression, exclude infection: Clostridioides difficile, and in severe steroid-refractory colitis cytomegalovirus in the biopsies. The commonest substitution is months spent treating a "flare" that is not there
- Surgery is a stage of treatment, not a defeat — with a short ileocaecal stricture, early resection performs comparably to escalating drugs
- Monitoring by numbers, not by feel — calprotectin, CRP, endoscopy scored on a scale. Without checkpoints, treatment becomes reaction to flares
Cellular and regenerative approaches do not replace this path. The off-the-shelf check-up is not taken as it stands here: it holds no colonoscopy with biopsy, no histology re-read and no calprotectin — those are added separately. If standard therapy has not held, send your records.
Where a programme begins
No programme starts without a work-up
Diagnostics come first: they decide whether the method is indicated in your case and to what extent. From here there are two possible next steps.
The regenerative approach
What the cluster additionally considers
On medical grounds — as an addition to standard care, never instead of it.
- The whole work-up in one trip, not over six months
Colonoscopy with biopsy, a re-read of the histology, intestinal ultrasound, calprotectin, pelvic MRI where there are fistulas — what at home takes months across several institutions is done here in days. When the approach changes, it is usually the slides that change it: the line between Crohn's disease and colitis is settled under a microscope, and treatment follows from it. One caveat: full colonoscopy is not done during a marked flare — perforation risk outweighs benefit. One more reason not to fly in an attack.
- Rebuilding the regimen, and drugs unavailable at home
Real doses and intervals are examined, and with them drug level monitoring: the concentration of the biologic in your blood, and antibodies against it. Those two numbers turn the choice between raising the dose and switching class from guesswork into arithmetic (caveat: monitoring is only a conditional recommendation, and physicians decide without it daily). Plus medicines unregistered in the rest of China — to be weighed against what you can get at home.
- How the result is measured
Not by how you feel: calprotectin, CRP, intestinal ultrasound and endoscopy scored on a scale (SES-CD in Crohn's disease, the Mayo score in colitis). The aim is durable remission with mucosal healing and life without systemic steroids; the checkpoints go into the discharge summary.
Methods
Which directions may be considered
What suits your case is determined by a physician after diagnostics.
Diagnostics built around your diagnosis
How the work-up is arranged in the cluster, and why in IBD the standard check-up has to be extended.
Second opinion on your records
The first answer decides whether you travel. A second opinion is a full written assessment of the diagnosis and the regimen.
Cellular technologies in the cluster
What the pilot zone permits, and how a technology is admitted to it. Why IBD has no cell therapy on that list — further down this page.
Traditional Chinese medicine
Led by Master Zhi Ning. In IBD the remit is narrow: sleep, stress, recovery after a flare, tolerating treatment. It does not treat inflammation and replaces no disease-modifying drug.
Plainly about the limits
When the regenerative route is not for you
This matters more than any marketing: knowing in advance when the method is not considered.
Go through this list first.
- An active flare right now — frequent bloody stool, fever, anaemia, weight loss. That means a hospital near home: a long flight is dangerous, and active inflammation raises the risk of thrombosis
- Untreated pus, or a stricture — an abscess has to be drained, and no cells will open a bowel narrowed by scar. That is surgery, not a reason to fly for a technology
- Standard therapy is not exhausted — anti-TNF never taken to an adequate dose, while drug level monitoring and the newer classes exist where you live. Better to start at home
- Active infection, cancer, or dysplasia found in the colon — infectious and oncological management comes first, and a trip only delays it
- Expecting cells to end lifelong therapy — no trial has shown cells producing durable remission off treatment. The one product that reached registration in the EU and Japan for Crohn's disease treated fistulas, it did not replace the regimen; its confirmatory trial missed its endpoint and sales have been withdrawn
If the cluster physician says there is no reason to come and it can be handled at home, we pass that on as it stands: a refusal on the records is an ordinary outcome. We do not sell a method — we organise access to a physician's decision.
How it works
From your records to coming home
- 11. You send your records
By WhatsApp or through the form; phone photographs are fine, a complete file is not needed. The coordinator replies the same day in working hours and says when the physician's answer is due. Go quiet and we remind you once, then leave you alone.
- 22. The answer: is there any point in coming
In writing, usually within a few working days. No diagnosis is made online: the approach is set by the physician who will see you.
- 33. Route and estimate
The route is built around your diagnosis: what is checked, in which hospital of the cluster, how many days — in IBD, reckon on about a week. Dates fall between biologic infusions: treatment is not paused for a trip, as that risks antibodies and loss of response. The estimate comes before tickets.
- 44. Arrival and diagnostics
International flights arrive at Sanya (SYX) and Haikou (HAK); from there a road transfer to the cluster in Qionghai — some 180 km and two and a half hours from Sanya. The coordinator meets you and interprets at appointments; that is in the estimate. If you become unwell, care is given here, but on the hospital's own bill, outside the trip.
- 55. Going home
Neither we nor the hospital can help at a distance, so continuity is agreed before departure. You leave with a discharge summary, a regimen and checkpoints written so a physician where you live can work from them. Ask for international non-proprietary names: the Chinese brand will not be recognised at home.
Why here
What the Boao Lecheng cluster offers
- Dr Yang reads Russian in the original
A partner physician of the cluster whose medical training was in Russia. Russian-language records he reads in the original, nothing lost in translation; records in other languages are translated before the review.
- The name of the drug, before the ticket
If there are grounds, the written answer names the drug or class available in the zone on the date of the enquiry, and says whether it exists where you live. If it is not in the zone, you learn that before tickets.
- No visa for up to 30 days
Hainan runs its own visa-free regime, and treatment is named in it explicitly as a permitted purpose — the nationwide Chinese scheme lists none. One condition: fly to the island directly, with no transfer through mainland China. Whether it covers your passport is checked before booking; programmes over 30 days need a visa arranged in advance.
- You pay the hospital directly
The hospital issues the bill and you pay its price — no mark-up on medicine. We are not a clinic and we do not treat: care is delivered by the zone's licensed hospitals, where medicines unregistered in the rest of China are legally available. Our support is a separate line in the estimate, sent before tickets.
Common questions
The essentials
Send your scans — and get a straight answer
A specialist physician in the cluster will look at your stage and say whether the regenerative route is worth considering. The review is free; we do not diagnose online.