Antioksidanlar ve kronik pankreatitli hastalarda ağrı kontrolü:Bitmeyen hikaye

Abstract: Chronic pancreatitis is a benign disease often characterized by recurrent episodes of abdominal pain accompanied by progressive pancreatic exocrine and endocrine insufficiency; it sometimes requires multiple hospitalizations. This disease is frequently the result of chronic alcohol abuse, even if other factors such as genetic alterations, autoimmune disorders, and obstructive disease of the biliary tract and the pancreas may cause the disease. The pain can be considered the most important symptom; it significantly modifies the quality of life of patients with chronic pancreatitis and its control represents a challenge in the treatment of the disease. Among the several modalities for controlling the painful symptomatology, in addition to the use of high doses of analgesics, adding antioxidant substances to the patient’s diet has been attempted. In this paper we review the most recent literature data about the use of antioxidants in alleviating the pancreatic pain.

Antiokxidans and pain control in patients with chronic pancreatitis:A never-ending story

PDF

___

1. Gullo L, Barbara L, Labò G. Effect of cessation of alcohol use on the course of pancreatic dysfunction in alcoholic pancreatitis. Gastroenterology 1988; 95: 1063-1068.
2. Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology 2001; 120: 682-707.
3. Pezzilli R, Morselli Labate AM, Ceciliato R, Frulloni L, Cavestro GM, Comparato G et al. Quality of life in patients with chronic pancreatitis. Dig Liver Dis 2005; 37: 181-189.
4. Malfertheiner P, Buchler M, Stanescu A, Ditschuneit H. Pancreatic morphology and function in relationship to pain in chronic pancreatitis. Int J Pancreatol 1987; 2: 59-66.
5. Ebbehoj N, Borly L, Bulow J, Rasmussen SG, Madsen P. Evaluation of pancreatic tissue fluid pressure and pain in chronic pancreatitis. A longitudinal study. Scand J Gastroenterol 1990; 25: 462-466.
6. Ebbehoj N, Borly L, Madsen P, Matzen P. Comparison of regional pancreatic tissue fluid pressure and endoscopic retrograde pancreatographic morphology in chronic pancreatitis. Scand J Gastroenterol 1990; 25: 756-760.
7. Jensen AR, Matzen P, Malchow-Moller A, Christoffersen I. Pattern of pain, duct morphology, and pancreatic function in chronic pancreatitis. A comparative study. Scand J Gastroenterol 1984; 19: 334-338.
8. Warshaw AL, Popp JW Jr, Schapiro RH. Long-term patency, pancreatic function, and pain relief after lateral pancreaticojejunostomy for chronic pancreatitis. Gastroenterology 1980; 79: 289-293.
9. Di Sebastiano P, di Mola FF, Buchler MW, Friess H. Pathogenesis of pain in chronic pancreatitis. Dig Dis 2004; 22: 267-272. 10. Gabbrielli A, Mutignani M, Pandolfi M, Perri V, Costamagna G. Endotherapy of early onset idiopathic chronic pancreatitis: results with long-term follow-up. Gastrointest Endosc 2002; 55: 488–493.
11. Howard TJ, Swofford JB, Wagner DL, Sherman S, Lehman GA. Quality of life after bilateral thoracoscopic splanchnicectomy: long-term evaluation in patients with chronic pancreatitis. J Gastrointest Surg 2002; 6: 845–852.
12. Leksowski K. Thoracoscopic splanchnicectomy for the relief of pain due to chronic pancreatitis. Surg Endosc 2001; 15: 592–596.
13. Holm M, Matzen P. Stenting and extracorporeal shock wave lithotripsy in chronic pancreatitis. Scand J Gastroenterol 2003; 38: 328–331.
14. Liao Q, Zhao YP, Wu WW, Li BL, Li JY. Diagnosis and treatment of chronic pancreatitis. Hepatobiliary Pancreat Dis Int 2003; 2: 445–44
15. Braganza JM. The pathogenesis of pancreatitis. Manchester, UK: Manchester University Press; 1991. 16. Braganza JM. The pathogenesis of chronic pancreatitis. Q J Med 1996; 89: 243-250.
17. Uden S, Acheson DW, Reeves J, Worthington HV, Hunt LP, Brown S et al. Antioxidants, enzyme induction, and chronic pancreatitis: a reappraisal following studies in patients on anticonvulsants. Eur J Clin Nutr 1988; 42: 561-569.
18. Uden S, Bilton D, Nathan L, Hunt LP, Main C, Braganza JM. Antioxidant treatment for recurrent pancreatitis: placebocontrolled trial. Aliment Pharmacol Ther 1990; 4: 357-371.
19. Uden S, Schofield G, Miller PF, Day JP, Bottiglieri T, Braganza JM. Antioxidant therapy for recurrent pancreatitis: biochemical principles in a placebo-controlled trial. Aliment Pharmacol Ther 1992; 6: 229-240.
20. Bilton D, Sconfield G, Mei G, Kay PM, Bottiglieri T, Braganza JM. Placebo-controlled trial of antioxidant therapy including Sadenosylmethionine in patients with recurrent non-gallstone pancreatitis. Drug Invest 1994; 8: 10-20.
21. Braganza JM, Hewitt CD, Day JP. Serum selenium in patients with chronic pancreatitis; lowest values during painful exacerbations. Trace Elements Med 1988; 5: 79-84.
22. Whitetely G, Kienkle A, Lee S, Taylor P, Schofield D, Braganza J. Micronutrients therapy in the non-surgical management of painful chronic pancreatitis: long-term observations. Pancreas 1994; 9:807.
23. Mathew P, Wyllie R, Van Lente F, Steffen RM, Kay MH. Antioxidants in hereditary pancreatitis. Am J Gastroenterol 1996;91: 1558-1562.
24. Uomo G, Talamini G, Rabitti PG. Antioxidant treatment in hereditary pancreatitis. A pilot study on three young patients. Dig Liver Dis 2001; 33: 58-62.
25. Toda S, Miyase T, Arichi H, Tanizawa H, Takino Y. Natural antioxidants. Antioxidative components isolated from rhizome of Curcuma longa L. Chem Pharm Bull (Tokyo) 1985; 33: 1725-1728.
26. Ammon HPT, Wahl MA. Pharmacology of Curcuma longa. Planta Med 1991; 57: 1-7.
27. Shoba G, Joy D, Joseph T, Majeed R, Rajendran, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med 1998; 64: 353-356.
28. Durgaprasad S, Pai CG, Vasanthkumar, Alvres JF, Namitha S. A pilot study of the antioxidant effect of curcumin in tropical pancreatitis. Indian J Med Res 2005; 122: 315-318.
29. Kirk GR, White JS, McKie L, Stevenson M, Young I, Clements WD et al. Combined antioxidant therapy reduces pain and improves quality of life in chronic pancreatitis. J Gastrointest Surg 2006; 10: 499-503.