Role of bile acids and endotoxins in the pathogenesis and treatment of psoriasis

Author: Dr. Klára Gyurcsovics and Dr. Lóránd Bertók, Professor
Source: Vitality Volume 141 (2000) Number 17/ http://www.vitalitas.hu/olvasosarok/online/oh/2000/17/5.htm
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Summary:
The authors treated 551 patients with psoriasis with oral bile acids for 1-8 weeks. The efficacy of the treatment was assessed by 'psoriasis extent and severity index'.
Of these patients, 434 (78.8%) became asymptomatic.
Of the 249 patients who received conventional treatment, only 62 (24.9%) were asymptomatic during the same period (p < 0.05).
In the acute form of psoriasis, treatment with bile acid was even more effective (95.1% symptom-free). At two-year follow-up, 319 (57.9%) of 551 patients treated with bile acid (acute and chronic combined) were asymptomatic (p < 0.05), compared to only 15 (6.0%) of 249 patients treated with conventional therapy.
In the acute cases, only 10 (7.2%) of 139 patients treated with conventional therapy and 147 (79.9%) of those treated with bile acid were asymptomatic (p < 0.01) after two years.
Table 1: Evaluation of bile acid treatment of psoriasis patients on the day of resolution/improvement

It is worth mentioning that, in addition to bile acid treatment, it is very important to regulate the patient's diet properly, avoiding strong spices (pepper, hot peppers, horseradish, bay leaves, etc.), short drinks, raw onions, garlic and carbonated soft drinks, but also to eat plenty of plant fibre (vegetables, fruit, etc.). The prolonged administration of bile acids with slow intestinal function may increase the incidence of malignant tumours of the colon, but this is unlikely to be significant with the treatment we recommend, because patients who are symptom-free should only take bile acids when eating heavier (fatty) meals, and not continuously.
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