DDW: Antioxidants for Pain Relief in Chronic Pancreatitis

May 24, 2007

WASHINGTON -- Vitamins C and E and other antioxidants may be an option for managing abdominal pain in patients suffering from chronic pancreatitis, according to a study presented here.

WASHINGTON, May 24 -- Vitamins C and E and other antioxidants may be an option for managing abdominal pain in patients suffering from chronic pancreatitis, according to a study presented here.

One-third (33%) of patients with chronic pancreatitis reported no pain after six months of antioxidant therapy, compared with only 13% of patients in a placebo group (P=0.009), reported Payal Bhardwaj, M.D., of the All India Institute of Medical Sciences, New Delhi, at the Digestive Disease Week conference.

Dr. Bhardwaj and colleagues hypothesized that the inflammation produced by oxidative stress may be causing the pain suffered by up to 90% of patients, and that antioxidant therapy might relieve that pain.

Previous studies exploring this hypothesis used only small numbers of patients and were not randomized, blinded, placebo-controlled trials, she said. In addition, she noted, the longest ran only six weeks.

The current study involved 127 chronic pancreatitis patients, mostly males, with an average age of 30. Of these, the condition was caused by alcohol consumption in 35 patients and was idiopathic in the others.

The patients were randomized to receive either placebo (n=56) or a daily combination of five antioxidants: 600 micrograms of selenium, 0.54 grams of vitamin C, 9000 international units of beta-carotene, 2,701 international units of vitamin E, and 2 gram of methionine (n=71).

At six-month follow up, the number of painful days per month averaged 3.4 for the placebo group and 1.7 for the treatment group (P=0.012). The placebo group took an average of 10.5 oral analgesics per month to help manage their pain, while the treatment group needed an average of only 4.4 (P=0.001).

Markers of oxidative stress, assessed by blood tests and spectrographic methods, were also significantly improved in the treatment group. For example, the amount of thiobarbituric acid reactive substances averaged 5.4 nmoles/ml in the placebo group versus 3.6 nmoles/ml in the treatment group (P=0.001). Furthermore, the level of serum superoxide dismutase was 27.3 U/mg/Hb in the placebo group and 51.1 U/mg/Hb in the treatment group (P