Russian version

Personal experience of treatment in 2012-13

Aliorum medicus ipse ulceribus scates

1. Prehistory
2. Facts of observation term (May 2012 - Feb 2013)
3. Purpose and observation term, dates
4. Results of two SIBO tests
5. Course of treatment (Sep 3-12, 2012)
6. Photo report (other page)
7. PASI in dates of photo sessions
8. Also what all it means?
Discussion about this experience at PHO forum

1. Prehistory

I do have psoriasis since age of 8. From age of 16 years I've managed to keep it in moderate condition thanks to dietetics and cleansing methods. As now I'm 58, the experience of conscious struggle against psoriasis is more than 40 years... Since 1996 I observe certain diets: New ration (rus) (1996-1999), Ration 2000 (rus) (2000-2005), Ration 2006 (eng) (from 2006 to now). Constant observance of diets and periodic 3-5 day unloading courses, including cleansing of intestine, provided low level of psoriasis. PASI no more than 10, the area of lesion no more than 10%, maximum in winter-spring time. From the middle of 2001 I conduct photo documenting, in 2002 published Photo report (rus) on influence of following (non-following) of John Pagano regimen on psoriasis.

....

In 2005 the article in Vestnik of Dermatology and Venerology has been published "Psoriasis as a consequence of incorporation of beta-streptococci into the microbiocenosis of highly permeable intestines (a pathogenic concept)"

Within the next several years (2006-2010) there was work conducted on the monograph "Model of pathogenesis of psoriasis", which first editions have been published in Russian (part 1 - in 2010, part 2 - in 2011), and then in English (both parts in 2011).

In 2009 series of works of group of researchers under the direction of professor Natalia Potaturkina-Nesterova (rus) has been published. For the first time in the world scientists of Ulyanovsk State University investigated small intestine microflora at patients with psoriasis. This data has entailed necessity of processing of the monograph, which last edition (in Russian and English) published in April, 2012.

....

Since 2010 I deliberately postponed such (as it was lead in Ulyanovsk) own SIBO (Small Intestinal Bacterial Overgrowth) test.
The reason is simple - I did not want the knowledge of my special case affected the concept formulated in the monograph.

Earlier I repeatedly received the information about my intestine microflora only on the basis of Gas Chromatography - Mass Spectrometry (GC-MS) blood analysis and (once) by small intestine biopsy. GC-MS research does not allow to define sensitivity of any microflora to antibiotics or bacteriophages. Therefore the subsequent courses of treatment did not contain them. I also twice (with interval of several years) was checked on small intestine permeability by ovalbumin-test. Both times have shown essential (in comparison with norm) increase of permeability.

.....

In the end of April 2012 also it became known that at the International conference in Stockholm it is necessary to give the report based on the first part of monograph and works of researchers from Ulyanovsk.

For this reason in the beginning of May 2012 I have decided to learn all the same how much my small intestine microflora is deviated from norm and whether it is deviated in general. About it some of especially attentive participants of dermatological conference could possibly ask (but have not asked ľ because of carelessness or politeness).

And well, of course, I hoped that if significant deviations will be found in my small intestine microflora it will be clear with what factors to struggle further.

After a week of active Internet and phone searches in Moscow I have found hospital in which they have agreed to do classical SIBO test. Namely gastroscopy (is more exact Esophagogastroduodenoscopy) ) with aspirate (and biopsy) capture in zone of ligament of Treitz (conditional border between Duodenum and Jejunum). Really both aspirate and biopsy captured on distance of 10 sm after ligament of Treitz. The capture of biomaterials immediately in duodenum before ligament of Treitz is quite admissible. Then the aspirate and biopsy were investigated by Microbial culturing in laboratory. For pathogenic bacteria (which were found out) sensitivity check to antibiotics and bacteriophages was lead. I.e. I went through the same examination which has been also executed for 121 patients with psoriasis during researches in Ulyanovsk plus in addition capture and biopsy crops has been carried.

And so - it was found out in me SIBO II degree (see section 4). And with appreciable including of beta-streptococci Str.agalatiae - 10┼4 CFU/ml, bacteria from among what I named psoragenic :-). Additional tests have shown that these Str.agalatiae are sensitive to one of bacteriophages, besides sensitivity to certain antibiotics

One of the hypotheses those offered in the monograph "Model of pathogenesis of psoriasis"

IB-Y – interpeptide bridges of peptidoglycan Str.pyogenes:
L-Ala(2-3) or L-Ala-L-Ser;
PG-Y – peptidoglycan containing interpeptide bridges IB-Y;
PsB – PsB - psoragenic bacteria is Gram (+) bacteria: Streptococcus pyogenes, Streptococcus agalactiae, Enterococcus faecalis, some from VGS (viridans group streptococci), and some from Bifidobacterium species.
All PsB have peptidoglycan PG-Y.

Circumstances have developed so that I have lead course of treatment (see section 5) only in September 2012. Before the beginning of course PASI was nearby 5-6. It was a consequence of two weeks at the sea resort. However experience shows that such decrease reached thanks to solar-sea baths would last for maximum of 1-3 months. And for these 1-3 months PASI inevitably would grow to preholiday level or even still above.So it was tens of times - in all years when I used the climatotherapy blessings. So it was always, but not this time!

Today, when I'm writing these lines, April 2013. Right after the course of treatment there has come a surprisingly deep and steady remission, so even "duty" plaques on elbows and knees almost completely passed. There were some pigmental spots and very small number of psoriatic dots. Such deep remission in my life had place only once (more than 30 years ago) - after I have excluded milk products from my ration.

It was natural to be checked up again on SIBO that I and did in the end of January 2013. The result was as expected (see section 4) - SIBO is not present (TBC < 10E3, and diagnosis SIBO is when TBC >= 10E5). Though in quantity less than 10E3, in biopsy were found beta-streptococci of other group, those showing sensitivity to the same bacteriophage. For this reason in the near future I assume to repeat course of treatment to try to tire out psoriasis into the invisible condition...

TBC = total bacterial count = total quantity of microorganisms which have been found out in 1 ml of biomaterial.

2. Facts of observation term (May 2012 - February 2013)

During all term of observations Ration 2006, was followed, and no additional treatments were applied, except for two weeks of moderate climatotherapy (sun + sea) in the end of July - the beginning of August.

Regimen components  
1. Cleansing procedures Intestine lavage (only 5 procedures during course of treatment in September)
2. Diet Ration 2006 - it is constant with small deviations during celebratory actions
3. Herb teas and additives No
4. Backbone therapy No. Alternative - yoga-exercises for back (1-2 times a week)
5. External agents Aloe-gel or aloe-cream for face and hands.
During Sep-Nov 2012 - skin cream Kartalin (only on the rests of punctual rashes on hands, feet and head).
6. Right thinking Fracture of vertebra as a result of falling at mum (83 years) was the most serious stress in family. I looked after mum independently three weeks in October. The next one and a half month it was done by the nurse. All has safely grown together within two months and mum again goes with walkers.
7. Physical exercises Mornings jogging from the beginning of April until the end of October, in the winter - skiing (1-2 times a week).

 

3. Purpose and observation term, dates

The observation purpose: To estimate action of observance of regimen + course of treatment. In case of success - to share the experience. The observation term has made more than eight months

Dates
Events
Section
May 25, 2012
SIBO test:
It is found out SIBO II degree.
4
May 30, 2012
Photo session (right after SIBO test)
6
Sep 3-12, 2012
Course of treatment: 10 day apple unloading diet + cleansing procedures + bacteriophage and enterosorbent reception (is more detailed low)
5
Nov 16, 2012
Photo session more than in two months after the course of treatment
6
Jan 28, 2013
SIBO test (control):
No SIBO.
4
Feb 12, 2013
Photo session in 5 months after the course of treatment
6
  

 

4. Results of two SIBO tests

Microflora

May 25, 2012 Aspirate / (*)
(CFU/ml)

Jan 28, 2013 Aspirate / biopsy
(CFU/ml)

Enterobacteriaceae
0
0 / 0
E.coli
0
0 / 0
Bifidobacterium species
10E7
0 / 0
Lactobacillus species
0
0 / 0
Enterococcus species
10E3 (**)
0 / 0
Beta-hemolitic Streptococcus
Str.agalactiae
10E4 (***)
0 / 0
Beta-hemolitic
Not group A and not group B
0
0 / <10E3 (***)
Staphylococci S.epidermidis and S.saprophyticus
0
0 / 0
Staphylococci S.aureus
10E3 (***)
0 / 0
Conditional-pathogenic enterobacterias
(Proteus spp., Klebsiella spp., etc.)
0
0 / 0
Non-fermenting bacteria
10E3 (****)
0 / 0
Candida Fungi
0
<10E3 / 0
Mold
0
0 / 0
Clostridium spp.
0
0 / 0
Diagnosis
SIBO II degree
(Ď┬Đ reaches 10E7 at the expense of anaerobic bifidobacterium)
No SIBO
(TBC less 10E5)

* - from the biopsy no cultures were obtained for unexplained reason

** - according to laboratory tests, it is not E.faecium and, hence, with high probability this is E.faecalis, as in 90% of cases from intestine contents these two kinds of enterococci are cultured only.

*** - have shown sensitivity to Piobacteriophage polyvalent cleared (rus). Also have appeared to be resistant to Streptococcal bacteriophage (rus).

**** - it is a false positive result, because simultaneously lead GC-MS analysis of blood, as well as biopsy has not shown the presence of signs of ostensibly found out Stenotrophomonas maltophilia (at it has a unique marker).

 

5. Course of treatment (from Sep 3 till Sep 12, 2012)

I lead such courses of treatment repeatedly, including those with bacteriophages. More details here (rus). However for the first time the bacteriophage is chosen not empirically, and on the basis of laboratory research of sensitivity of found out Str.agalactiae

Components Daily
Apple diet Meal in 9, in 14 and in 19 o'clock. It is authorized only: natural apple juice (without sugar) preserved or of fresh preparation - without restrictions. Water - without restrictions (it is possible drink mineral water due to taste). Raw apples - two-three in one meal. If in doubt about the apple’s skin (if they were  stored, possibly covered by wax) - eat without it. In the evening preferably stewed apples.
If it is very sad, one tea spoon of honey.
Intestinal lavage Lead in house conditions.
Only 5 times (it is optimum every other day, it has turned out - in 1,3,5,8 and 10 days) in the morning on an empty stomach.
These days the morning meal is simply cancelled, as the procedure as a rule occupies no less than 3-4 hours.

Piobacteriophage polyvalent cleared (rus),

Microgen production (rus)

120 ml (40 ml § 3 times) daily, 1 hour prior to meal reception (in 8, 13 and at 18 o'clock).
Immediately after bacteriophage I recommend to drink water (100-200 ml).

Those days, when only two meals (because of the intestine lavage)* - in two steps (60 ml § 2 times), 1 hour prior to meal reception (in 13 and at 18 o'clock).
In total for course 1200 ml (15 complete sets on 80 ml in everyone) has been drunk.

* Victor Matkevich (author of intestinal lavage method) recommends adding the first daily dose of bacteriophage (60 ml) at the last glass of the solution drunk during intestinal lavage. This is more effective than drinking water after bacteriophage.

Polisorb 5 g before sleep (1 item spoon without top = 1 g). To stir in warm water. To drink, and then to wash down with water (or mineral water).
Physical exercises Mainly the elementary yoga-exercise (15-30 min)
Bowel movement Should occur daily (it is desirable and those days in the morning when intestine lavage is lead). If it is broken, accept easy laxative, and in the first days of the regenerative term emphasize corresponding products (boiled beet, prunes, figs, etc.)
Sleep Totally not less than 8-9 hours, at feeling sick in addition day sleep of 1,5-2 hours (between dinner and supper) is recommended.

Notes:

1. As a result of this dieting course the weight has decreased on 2 kg (from 67 to 65). First of all at the expense of excesses around waist. In the last half a year the weight remains in range of 63-65 kg.

2. Reception of enterosorbent of Polisorb has probably prevented temporary aggravations  of psoriasis in the course of treatment and right after (Herxheimer effect). However its long reception may promote constipations, therefore during following course of treatment I assume not to accept it or replace with other enterosorbent.

3. The basic financial expenses went on components for intestine lavage and on bacteriophage (totally about 500 euros). However those money have perfectly worked!

 

6. Photo report 2012-13 (-: click and look gloomy and cheerful pictures of limbs :-)

 

7. PASI in dates of photo sessions

May 30, 2012   Lesion area  
Body part Share In palms In %% Area Itching Redness Scaling Thickness PASI
Head
0,1
3
30
3
0
2
1
1
1,2
Arms
0,2
2
10
2
0
2
2
2
2,4
Trunk
0,3
0,1
0,33
0
0
0
0
0
0
Feet
0,4
6
15
2
0
2
2
2
4,8
Total
11,1
11,1
8,4

 

Nov 16, 2012   Lesion area  
Body part Share In palms In %% Area Itching Redness Scaling Thickness PASI
Head
0,1
0,5
5
1
0
1
1
1
0,3
Arms
0,2
1
5
1
0
1
1
1
0,6
Trunk
0,3
0
0
0
0
0
0
0
0
Feet
0,4
2
5
1
0
1
1
1
1,2
Total
3,5
3,5
2,1

 

Feb 12, 2013   Lesion area  
Body part Share In palms In %% Area Itching Redness Scaling Thickness PASI
Head
0,1
0,5
5
1
0
0
0
1
0,1
Arms
0,2
0,5
2,5
1
0
0
0
1
0,2
Trunk
0,3
0
0
0
0
0
0
0
0
Feet
0,4
1
2,5
1
0
1
1
1
1,2
Total
2
2
1,5
* Today (at Apr 12, 2013) my skin condition is the same.

8. Also what all it means?

Many years my psoriasis was at level nearby PASI=10, and sometimes it was more. Temporary (for 1-3 months) decrease came out of climatotherapy (sun + sea) and-or after fruit cleansing courses. I accurately observe the chosen diet (Ration 2006), I have no bad habits, and moderately I’m  going  in for sports. I have no gastroenterologic problems. And in general I rarely address to doctors  - there are no occasions. And nevertheless it has appeared that at me is SIBO II degree (TBC = 10E7), and with including of psoragenic bacteria Str.agalactiae (10E4).

Well - I have taken active measures to get rid of them. In apple based cleansing course of treatment (which I repeatedly lead before) I has added reception of the certain bacteriophage (to which psoragenic bacteria have shown sensitivity). As control examination shows - I have got rid from SIBO and have almost got rid of psoragenic bacteria. And that the most important, I’ve almost got rid of psoriasis (PASI=1,5).

My advices:
Necessarily carry out SIBO test. And, if it will be found out SIBO with psoragenic bacteria take measures to elimination both.
If you get rid of them it is rather probable that
psoriasis will leave you!

Mikhail Inq
Moscow, April 12, 2013

Mikhail Inq is forum nickname of Mikhail Peslyak.
He is the author of web-sites:
"Psoriasis as intestinal disease - treatment" (rus)
and
"Psoriasis as intestinal disease - theory" (eng/rus).

Mikhail is russian translator of John Pagano's book
"Healing Psoriasis - The Natural Alternative".

He is the author of several articles about psoriasis pathogenesis and
of the monograph "Model of pathogenesis of psoriasis".

Last year he reported at the
3rd WORLD PSORIASIS & PSORIATIC ARTHRITIS CONFERENCE
(Stockholm 2012
).

 

Discussion about this experience at PHO forum
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