As a part of the project “Natural Way to Remission,” patients learn about basic diets, methods for creating individual diets, fasting diets, gastrointestinal cleansing procedures, and monitoring psoriasis using PASI. The information is provided on necessary tests and procedures, provoking diseases of oral cavity, diseases of upper respiratory tract and gastrointestinal tract, SIBO (small intestinal bacterial overgrowth) , i.e. about everything that affects or can affect psoriatic disease negatively or positively.
The Guide (Questionnaire) has been developed and improved over several years, with participation of leading medical specialists, support of Antipsoriatic Association, and also involving communication with psoriatic patients. Between 2013 and 2021, many psoriatic patients gradually eliminated the influencing problems, switched to individualized diets, underwent one or more courses of treatment, changed their lifestyles to healthier ones, and achieved a long-term and sustainable psoriatic disease remission.
| Psoriatic Patient Guide (Questionnaire) | |
| A1 | Introduction |
| A1.1 | This Guide is intended for psoriatic patients who admit that psoriatic disease is a consequence of increased kPAMP level in blood. kPAMP are specific bacterial products: LPS – lipopolysaccharide, PG – peptidoglycan and bacterial DNA. |
| A1.2 | Two main factors for increased kPAMP level in blood: SP1. Small intestinal hyperpermeability for bacterial products with PAMP. SP2. Small intestinal bacterial overgrowth (SIBO) with PsB-bacteria. One of these two factors is enough to maintain psoriatic disease. See psoriasis pathogenesis model. |
| A1.3 | The main purpose of filling in this Guide and performing tests and procedures is to identify characteristics of the two main factors. Besides, another aim is to identify other factors that provoke the increase of SP1 and (or) SP2. In case of identification of factors influencing (provoking and/or aggravating) the two main factors, a patient will have to undergo course(s) of treatment and/or change their lifestyle to eliminate (reduce the impact of) the influencing factors. Influencing factors include, but are not limited to, excess weight, chronic oral and URT infections, Helicobacter, helminths, impaired peristalsis, etc. Elimination (reduction of impact) of the influencing factors, normalization of the level of the two main factors will lead to a long-term and sustainable psoriatic disease remission. |
| A1.4 | The filled Guide, as well as the results of tests and examinations, monitoring of symptoms, sleep and rest, exercise, diet, etc. (in the form of files or read-only access to resources) allows health coach to give recommendations on the individual diet, treatment courses, exercise and, in general, lifestyle. |
| A1.5 | The main goal of treatment courses and individual diet is to normalize (or reduce) kPAMP level in blood. In case of normalization (or reduction) kPAMP level in blood, long-term and stable remission of psoriatic disease will be achieved. |
| A1.6 | See for Abbreviations and terms with links to detailed descriptions. |
| A2 | Recommendations for filling in the Guide (Questionnaire) |
| A2.1 | It is necessary to answer questions in detail. Place your answers only in the empty line following the question. You can add more lines. In particular, to indicate external links. Since it is impossible to indicate more than one external link in one line. |
| A2.2 | It is necessary to report illnesses: when they occurred, whether they exist now, how you treated them, what are results of treatment. |
| A2.3 | It is necessary to attach files with scanned copies and/or photos of test results and expert opinions, and place file names and make links to them in the Guide. As an alternative, please, provide read access to your account in a relevant application (more details on “Patient Data” list). |
| A2.4 | If you filled in one of the previous versions of this Guide before, you need to transfer all information to this version and then update it. |
| A2.5 | Please include your name or nickname in your Word Guide file name as follows: Guide_NNN.docx |
| A2.6 | Please select one of the following three alternative information exchange options. |
| A2.6.1 | Save the Guide file on your Google Drive in a separate directory. Fill in the Guide via Google Docs application. Add additional files to this directory (test results, procedures, expert opinions) and then provide access to this directory for my E-mail. |
| A2.6.2 | Store and fill in the Guide and all additional files in the directory on your computer. When finished, place this directory on your Google Drive and provide access to it for my E-mail. |
| A2.6.3 | Send a file with the completed Form and additional files to my Email. |
| A2.6.4 | My Email – psorias.info@gmail.com. |
| A2.7 | After this, you will receive recommendations on the optimal set of tests and procedures for you, which are highly advisable to perform before creating individual diet and treatment courses. |
The Guide consists of 14 sections. The results of tests and examinations are considered relevant if completed no earlier than one year from the date of filling in the Guide. If you do not have up-to-date results when you initially fill out the Guide, you can provide older results. However, they will need to be updated later. The results of genetic tests are an exception, since they do not have expiration date.
Some sections of the Guide (as well as individual items in other sections) must be completed during the initial filling in. These sections and items are marked bold. The subsequent completion of the Guide, additional tests and examinations must be carried out according to health coach’s recommendations.
Almost all non-invasive tests and examinations will need to be performed (if not previously performed during the last year). The need for invasive testing will depend on the results of non-invasive tests (sections 8, 9 and 10) and health coach’s recommendations.
In cases where biomaterial can be collected independently (swab from oral mucosa, exhaled air, urine, feces, etc.), many laboratories offer test kits with home delivery. This allows you to collect biomaterial at home in special test tubes, send it to a laboratory by mail, and see results in your account or receive them by email.
Each section of the Guide starts on a new page. It is more convenient to view and fill out the Guide on a desktop.
Guide (Questionnaire) Sections | |
| 1 | Patient data |
| Items 1.1-1-9 in this section must be completed. The remaining items (if possible) will be filled in during cooperation process. | |
| 2 | Psoriatic disease ** |
| psoriasis.org (definition) | |
| All items in this section (except 2.13-2.16) must be completed. Item 2.13-2.16 (if necessary) will be filled in during the cooperation process. | |
| 3 | PASI definition |
| All items in this section must be completed. | |
| 4 | Standard blood tests |
| In this section, please complete as many items as possible. Any remaining items should be completed at the very beginning of the cooperation process. | |
| Necessary for the objective assessment of a patient’s health condition. | |
| 5 | Oral and URT (upper respiratory tract) diseases ** |
| Answers to questions 5.1 and 5.4 are mandatory. | |
| Chronic infectious diseases of oral cavity and URT are constant factor that maintains small intestinal bacterial overgrowth (SIBO). Particularly unfavorable are infections caused by presumable psoriagenic bacteria. | |
| 6 | Bacterial (or fungal) сulture and susceptibility (reference section) |
| This section is not to be filled in. Results are entered in those sections (marked **) that contain links to tests listed in this section. | |
| Bacterial and (or) fungal carriage is constant factor that aggravates psoriatic disease course if present on psoriatic skin. If such pathogenic carriage is present in the oral cavity, upper respiratory tract, or bile, it contributes to small intestinal overgrowth syndrome (SIBO). And if among bacteria there are presumable psoriagenic ones, then such effect is critical. | |
| 7 | Diet, food allergens and Potentially Problematic Substances |
| Answers to questions 7.1 – 7.4 are mandatory. The remaining items (if necessary) will be filled in during the cooperation process. | |
| Tests for food allergens may not be performed if the answer to item 7.3 is “no”. | |
| Testing for lactose intolerance is required. At least one of tests 7.8-7.11 must be performed. | |
| Testing for (latent) celiac disease is required. Tests 7.12-7.18 must be performed. | |
| Information on basic diet, tests for food allergens, as well as for some Potentially Problematic Substances (lactose, gluten and others) are intended to identify factors that provoke two main factors supporting psoriatic disease. This information is necessary for formation of individual diet. | |
| 8 | Helicobacter pylori, research and tests ** |
| Answer to question 8.1 is mandatory. | |
| Helicobacter infection in gastric mucosa and/or duodenum mucosa aggravates psoriatic disease course. Helicobacter can be cause of hypochlorhydria (one of small intestinal bacterial overgrowth (SIBO) causes). Hypochlorhydria can occur for long time (several months) even after Helicobacter elimination. | |
| 9 | Hepatobiliary system and pancreas ** |
| Answers to questions 9.1 and 9.2 are mandatory. | |
| Examination of these systems allows to identify deviations from a norm, determine their severity, assess impact on small intestinal bacterial overgrowth (SIBO) and, perhaps, first conduct a course of treatment to normalize their functioning. | |
| 10 | Gastroenterological diseases, research and tests ** |
| Answers to questions 10.1 and 10.2 are mandatory. | |
| This section is designed to identify characteristics of the two main factors supporting psoriatic disease – small intestinal permeability and small intestinal bacterial overgrowth (SIBO). This section is also designed to identify other factors (diseases or syndromes) that provoke increase in the level of the two main factors. For more details, see Section 11. | |
| 11 | Risk factors for development and maintenance of small intestinal bacterial overgrowth (SIBO) |
| All items in this section must be completed. | |
| This section is intended to identify these factors (in addition to those already listed in other sections). | |
| 12 | Basic regimen |
| All items in this section must be completed. | |
| Nutrition, intestine cleansing, exercise, etc. Regimen requires following the rules. Regimen includes planning and keeping diaries. Regimen is a combination of diet and meal schedules, medication schedules, and procedures. Regimen may also include sleep and rest schedule, exercise, or yoga. Regimen includes keeping diaries of psoriatic disease, as well as other symptoms that are or may be related to psoriatic disease severity. | |
| 13 | Contraindications to intestine lavage procedure |
| All items in this section must be completed. | |
| One of important components of treatment courses is intestine lavage. This section is intended to identify contraindications to this procedure. | |
| See article “What is intestinal lavage?” | |
| 14 | Small intestinal bacterial overgrowth (SIBO) treatment course |
| All items must be filled in if you have previouslyundergone one (or more) such course of treatment. | |
| Additional tables | |
| 15 | US Provider Search |
| US provider search by procedure. This tab contains the main resources for searching for procedure providers in the United States. You can use one of several of them to find the most suitable provider (by location and/or by cost). You can search using codes, but also by keywords in the procedure name. | |
| 16 | Reference section |
| Resources describing diseases, syndromes, tests and procedures. | |
| 17 | LOINC code sets for cases where a test or procedure is described by more than one code. If one code is sufficient, then the reference to it is in the last column of the corresponding row. LOINC. The international standard for identifying health measurements, observations, and documents. |
Since 2025, support for the project has been implemented for any English-reading patients.
To participate in the project, a patient only needs to be able to correspond in one of the following languages:
Russian, Ukrainian, Slovenian, Spanish or English.