By Em Brown
WASHINGTON, DC -- May 28, 2007 -- Use of antioxidant supplementation provides significant pain relief in patients with chronic pancreatitis, researchers reported here at Digestive Disease Week (DDW).
Pain control is difficult in chronic pancreatitis and the options for treatment are limited. The investigators noted that narcotics have limited efficacy, plus long-term treatment introduces another set of problems, including pain tolerance and addiction.
Oxidant stress is implicated in the pathogenesis of chronic pancreatitis and may be a source of the severe pain that can accompany the disease.
Payal Bhardwaj, PhD, department of gastroenterology, All India Institute of Medical Sciences, New Delhi, India, and colleagues tested whether or not antioxidants affected pain status in 71 patients with chronic pancreatitis who were randomized to either placebo or antioxidant supplements for 6 months.
Supplements included a daily regimen that consisted of 0.54 g of vitamin C, 600 mcg of selenium, 9,000 IU of beta carotene, 270 IU of vitamin E, and 2 g of methionine.
After 6 months, there were 1.68 painful days per month in patients on antioxidants compared with 3.4 days in patients on placebo. Placebo patients used oral analgesics 10.5 times a month compared with 4.4 times a month in patients receiving antioxidant supplements.
At the end of the study period, 33% of patients taking antioxidants were pain-free compared with 13% of patients on placebo.
Dr. Bhardwaj pointed out that it is difficult to assess pain levels. She said her team was careful to use objective measures of oxidative stress in addition to the patients' perceptions of pain severity.
"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," Dr. Bhardwaj told meeting attendees.
[Presentation title: Antioxidant Supplementation for Pain Relief in Chronic Pancreatitis: a Randomized Placebo Controlled Double Blind Trial. Abstract 271]
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