The symptoms of a stricture forming can be very subtle, and easily missed. My daughter was misdiagnosed for two years, partly because she never had D. Also, no pain UNLESS she found just the right spot (which the docs never seemed to be able to do) and pressed really really hard. She had loud abdominal noises (which we now know were caused by the stricture), which were dismissed as normal by the doc.
Then, one night at college, she had some mild cramping - ignored it and ate popcorn. Woke up at 5 AM vomiting, in the worst pain of her life...waves of pain like the pain of childbirth. Went to the student health center - they called me and said she might have a virus, and that they would keep her there to watch her. A doc who saw here, there, said, "She looks pretty good to me," but the nurse answered, "Well, a few minutes ago, she was writhing in pain."
The doc noticed pain when pressing on the LRQ so I then received another call, saying she was being sent by ambulance to the hospital, for suspected appendicitis. Thank goodness the hospital took a cat scan that showed the appendix was fine, but suspicious narrowing in the terminal ileum. At least they didn't mistakenly take out her appendix.
So yes, inflammation can cause fairly silent damage...and by the time the strongest symptoms show up, the damage might be irreversible. In her case, thanks to SCD diet and Entocort, the stricture is gone...but it took about a year for it to go away. If the stricture had been scar tissue, the damage would have been permanent.
Daughter (22) Dx'd Crohn's 3/06. Misdiagnosed for two years, including by top pediatric Crohn's specialist as stress. No symptoms for the past three years. March '09 colonoscopy showed stricture gone but two spots of inflammation in TI. Used LDN to taper off Entocort last fall. (Was on Entocort since April 06.) Never had D. 4.5 mg LDN, SCD multivit, homemade yogurt, 2000IU vit D3, 1000 mg calcium, 27-54 mg iron, monthly B12 shots, daily oral B12 twice a day (one B complex, then later one B 500), 10mg zinc. SCD diet.