Antioxidants may alleviate pain in pancreatitis.
Article Type: Report
Subject: Antioxidants (Health aspects)
Pancreatitis (Risk factors)
Pancreatitis (Physiological aspects)
Oxidative stress (Research)
Oxidative stress (Physiological aspects)
Pain (Care and treatment)
Pain (Research)
Pain (Physiological aspects)
Author: Hunter, Kim
Pub Date: 03/22/2009
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Spring, 2009 Source Volume: 21 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 200253724
Full Text: Bhardwaj P et al. 2009. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterol 136:1;149-59.

Acting on the observation that oxidative stress has been implicated in the pathophysiology of chronic pancreatitis CP), the authors evaluated the effects of antioxidant supplementation on pain relief, oxidative stress and antioxidant status in patients with CP. A number of patients 127) with CP were randomized to groups that were given placebo or antioxidants for 6 months. Antioxidants used were daily supplements of 600 mg of organic selenium, 0.54 g ascorbic acid, 9,000 IU beta-carotene, 270 IU alpha-tocopherol and 2 g methionine. The primary outcome measure was pain relief, and secondary outcome measures were analgesic requirements, hospitalisation and markers of oxidative stress.

After 6 months the reduction in the number of painful days per month was significantly higher in the antioxidant group compared to the placebo group. The reduction in the number of analgesic tablets per month was also higher in the antioxidant group. Furthermore 32% and 13% of patients became pain free in the antioxidant and placebo groups respectively. Reduction in antioxidant stress markers was also significantly higher in the antioxidant group compared with the placebo group.

The researchers add that the beneficial effect of antioxidants on pain relief was noted early at three months.

Concluding that antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP, the authors suggested two important implications: firstly an initial increase and subsequent decrease in levels of oxidative stress after supplementation indicated that CP is partly characterised by a state of heightened free radical mediated injury. The subsequent reduction suggested that this injury is reversible. The authors consider that if oxidative stress is not the sole factor or the initiating factor for pancreatic inflammation, it appears to be playing an important role in either precipitating or perpetuating pancreatic inflammation. Secondly the trial showed that antioxidant supplements could be effective as pain relief in patients with CP. This assumes significance since no effective medical therapy exists for pain relief for such patients.

Kim Hunter
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