One hundred and twenty-seven people took part in the randomised, placebo-controlled study, published in the January issue of Gastroenterology, which found that at the end of the intervention period 32 per cent of pancreatitis patients became pain-free, compared to only 13 per cent in the placebo group.
"We are encouraged by our findings, as significant improvement was noted with antioxidants in respect to all the parameters of pain in this study,” said Pramod Kumar Garg of the All India Institute of Medical Sciences in New Delhi, and lead author of the study.
“In addition, reduction in pain resulted in fewer man-days lost, thus providing functional employment gain to the patients. The findings should spur further research in this exciting area."
Study details
The researchers investigated the potential of antioxidants since oxidative stress is implicated in the development of chronic pancreatitis (CP).
The researchers recruited 127 patients with pancreatitis, and assigned them to receive daily supplements of antioxidants (600 micrograms of organic selenium, 0.54 g ascorbic acid, 9,000 IU beta-carotene, 270 IU alpha- tocopherol and 2 g methionine), or placebo for six months.
At the end of the intervention period, Garg and his co-workers report that patients in the antioxidant group experienced a 7.4 per cent reduction in the number of painful days per month. This was significantly more that the 3.2 per cent reduction in the placebo group.
Moreover, a significant reduction in the number of analgesic tablets taken per month was also reported in the antioxidant group (10.5 versus 4.4 in the placebo group).
The researchers add that the beneficial effect of antioxidants on pain relief was noted early at three months.
Markers of oxidative stress decreased in the antioxidant group, as measured by both TBARS and FRAP assays.
Implications
Garg and his co-workers said that the results suggested two important implications: Firstly, an initial increase and subsequent decrease in levels of oxidative stress after supplementation indicated that CP is partly characterized by a state of heightened free radical mediated injury. Moreover, the subsequent reduction suggested that this injury is reversible.
“Even if oxidative stress is not the sole factor or the initiating factor for pancreatic inflammation, it seems to be playing an important role in either precipitating or perpetuating pancreatic inflammation,” wrote Garg.
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,” they said.
“Antioxidant supplementation was effective in relieving abdominal pain in patients with CP and that it led to a significant decrease in oxidative stress in these patients supporting the oxidative stress hypothesis in the etiopathogenesis of CP,” concluded the authors.
Source: GastroenterologyJanuary 2009, Volume 136, Issue 1, Pages 149-159.e2“A Randomized Controlled Trial of Antioxidant Supplementation for Pain Relief in Patients With Chronic Pancreatitis”Authors: P. Bhardwaj, P.K. Garg, S.K. Maulik, A. Saraya, R.K. Tandon, S.K. Acharya