By Megan Rauscher

NEW YORK (Reuters Health) – In a randomized controlled trial, daily antioxidant supplementation relieved pain and reduced oxidative stress in patients with chronic pancreatitis.

In comments to Reuters Health, study investigator Dr. Pramod K. Garg said: “Patients with chronic pancreatitis are deficient in antioxidants probably due to the dual effect of suboptimal diet and the effect of maldigestion. Oxidative stress is an important pathophysiological mechanism of injury and inflammation of the pancreas in chronic pancreatitis.”

In the January issue of Gastroenterology, Dr. Garg and colleagues from the All India Institute of Medical Sciences in New Delhi report on 127 chronic pancreatitis patients who were randomly assigned to placebo or daily doses of 600 ug organic selenium, 0.54 g ascorbic acid, 9000 IU beta-carotene, 270 IU alpha-tocopherol and 2 g methionine. All patients were treated in the standard manner with analgesics on demand and pancreatic enzyme replacement therapy.

After 6 months, the reduction in the number of painful days per month was significantly higher in the antioxidant arm than the placebo arm (7.4 vs 3.2, respectively; p<0.001). The reduction in the number of analgesic tablets per month was also higher in the antioxidant arm (10.5 vs 4.4, respectively; p<0.001). “Significantly,” Dr. Garg told Reuters Health, “one third of patients became pain free on treatment.” There were also clear differences between the groups in markers of oxidative stress, “supporting the oxidative stress hypothesis in the etiopathogenesis of chronic pancreatitis.” “Patients with chronic pancreatitis,” Dr. Garg noted, “suffer from significant abdominal pain for which no effective medical therapy is available. The common causes of chronic pancreatitis are alcohol, genetic mutations, and idiopathic. Besides medication, abstinence from alcohol and quitting smoking are very important for such patients.” Moreover, with regard to management, the current study indicates that supplementation with antioxidant therapy is effective therapy for pain relief in chronic pancreatitis patients. Reference:
Gastroenterol 2009;136:149-159.