While Washington has been absorbed in battles over health care and incipient scandals, a real war is escalating sharply in Syria and Iraq: the one against Islamic State.

Without much public notice, thousands of U.S. combat troops are back on the ground in the Middle East: roughly 7,000 in Iraq, almost 1,000 in Syria and 2,500 in Kuwait.

Those troops arenโ€™t only special operations forces; they include artillery teams fighting in Iraq and a helicopter unit that has flown behind Islamic State lines in Syria.

U.S. airstrikes have intensified, too, and civilian casualties have spiked dramatically since the beginning of the year. As many as 200 civilians may have been killed in Mosul last week; the Pentagon says itโ€™s investigating.

The death toll is a tragedy. But itโ€™s also a grim sign that the long offensive against Islamic State, begun by President Obama in 2014, is moving rapidly toward success โ€” and for that, President Trump deserves some credit.

Under Obama, who waged a โ€œlight footprintโ€ strategy with minimal U.S. troops, Islamic State lost most of the territory it once held in Iraq and almost a third of what it held in Syria.

But taking the extremist groupโ€™s most important strongholds, Mosul in Iraq and Raqqah in Syria, was taking longer.

Enter Trump. The new president, after claiming he had a secret plan to win the war, told his generals to give him one in 30 days. They responded with an outline โ€” a โ€œskeleton plan,โ€ in the words of Defense Secretary James Mattis ๏ฟฝ that could be described as Obama Plus: more bombing, more troops, fewer restrictions on commanders.

โ€œThe Obama strategy wasnโ€™t failing, but it was slow,โ€ James Jeffrey, a former ambassador (and former Army officer) whoโ€™s advising the administration, told me. โ€œThis is more โ€” not only more troops, but more willingness to use them. Itโ€™s a change of maybe 20 percent, but itโ€™s an important 20 percent.โ€

Paradoxically, the success of those changes comes with its own danger: the peril of โ€œcatastrophic success,โ€ a phrase military officials use to describe the 2003 invasion of Iraq. That experience taught a lesson: Conquering territory doesnโ€™t guarantee that a war will stay won. So Trump administration officials are quietly planning for an open-ended commitment of U.S. troops to both Iraq and Syria for โ€œstabilization operationsโ€ after Islamic State is defeated. And that may well require more American troops, not fewer.

In Iraq, stabilization means persuading the government in Baghdad, which told U.S. forces to leave in 2010, to let them stay longer.

In Syria, where the U.S. doesnโ€™t want to cooperate with the government of President Bashar Assad, it means setting up an interim administration of local leaders under the protection of U.S. and allied troops.

A State Department official said stabilization means โ€œmaking sure people can come back to their homes, thereโ€™s a security apparatus in place thatโ€™s locally based, thereโ€™s a local government in place.โ€

In Jeffreyโ€™s view, it also means a continued effort to negotiate the Assad regime out of power. โ€œIf the Assad regime remains in power, youโ€™ll just get another (Islamic State),โ€ he said.

It all sounds expensive, ambitious and not quite in keeping with Trumpโ€™s campaign promise to take the U.S. โ€œout of the nation-building business.โ€

That may be one reason officials take pains to say their goals are limited.

โ€œStabilization … is very distinct from long-term reconstruction, long-term nation-building,โ€ a State Department official said.

Eventually, officials say, they hope the oil-rich countries of the Persian Gulf will pay to rebuild Syria and Iraq. Good luck with that.

One more dilemma: To make stabilization work, Trump is going to have to spend money on the State Department and foreign aid agencies whose budget he wants to cut. (Thatโ€™s not just my civilian opinion; Mattis says that every time he appears before Congress.)

It all sounds a lot more complicated than the strategy Trump suggested in his campaign.

โ€œI would bomb the … out of them,โ€ he said then, using profanity. โ€œIโ€™d blow up every single inch. There would be nothing left. And you know what? Youโ€™ll get Exxon to come in there, and in two months … theyโ€™ll rebuild it brand new.โ€

โ€œAnd Iโ€™ll take the oil,โ€ he added.

It wonโ€™t be anywhere near that simple โ€” or that rewarding โ€” but if Trump listens to Mattis he might just achieve a goal that eluded his predecessor: pacifying Iraq and Syria.

Doyle McManus is a columnist for the Los Angeles Times.