Antioxidant Supplementation for Pain Relief in Chronic Pancreatitis

To study the effect of antioxidant supplementation on pain relief, oxidative stress and antioxidant status in CP, the team randomized patients with CP and abdominal pain to receive either placebo (n=56) or antioxidants (n=71) (600�g selenium, 0.54g vitamin C, 9000IU �-carotene, 270IU vitamin E, 2g methionine) daily for six months between October 2003 through January 2006 in a double blind trial. Patients were then evaluated for pain relief using variables such as the number of painful days per month, number of oral and IV analgesics required per month, number of hospitalization episodes per month and percentage of patients who were pain free. The team also assessed markers of oxidative stress [thiobarbituric acid reactive substances (TBARS), serum superoxide dismutase (s-SOD)] and antioxidant status [ferric reducing ability of plasma (FRAP), vitamins A, C and E, erythrocyte SOD (e-SOD), erythrocyte total glutathione (E-TGSH)].

According to the study results, antioxidant supplementation was effective in relieving pain related to CP, with reduced levels of oxidative stress and increases in antioxidant status. In particular, the number of painful days per month was 1.68 after supplementation compared to 3.4 in the placebo group, while the percent of pain-free patients rose from 13 percent in the placebo group to 33 percent in the treated group. Vitamin C and E levels were higher in the treated group, along with other important markers of antioxidant status (FRAP, e-SOD, E-TGSH). Importantly, measures of oxidative stress (TBARS, s-SOD) were reduced in the treated group. Overall, the team found that antioxidant supplementation was the only independent predictor of response.

"We continue to find new beneficial properties of antioxidants and studies like these offer clinical evidence of their important role in maintaining health among patients who have experienced oxidative stress," said Payal Bhardwaj, Ph.D., of the All India Institute of Medical Sciences, and lead investigator of the trial. "We hope that continued research will determine the best combination of antioxidants at the best dose to provide effective supplemental treatment and possibly one day, prevention." -American Gastroenterological Association