Vitamin E and C

Vitamin E and C

PEP Topic 
Radiation-Induced Diarrhea
Description 

Vitamin E is a fat-soluble vitamin found in seeds, nuts, leafy vegetables, and vegetable oils that has antioxidant properties. Vitamin C is a water-soluble vitamin that also has antioxidant properties. The combination of these two vitamins has been evaluated in patients with cancer for the treatment of radiation-induced diarrhea.

Effectiveness Not Established

Research Evidence Summaries

Kennedy, M., Bruninga, K., Mutlu, E.A., Losurdo, J., Choudhary, S., & Keshavarzian, A. (2001). Successful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C. American Journal of Gastroenterology, 96(4), 1080–1084.

doi: 10.1111%2Fj.1572-0241.2001.03742.x
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Study Purpose:

To determine whether antioxidant vitamins, by counteracting oxygen-free radical injury, would relieve symptoms of chronic radiation proctitis

Intervention Characteristics/Basic Study Process:

Patients received 400 IU vitamin E and 500 mg vitamin C three times per day for eight weeks.

Sample Characteristics:

  • This study reported on 20 consecutive patients (10 prostate cancer survivors and 10 gynecologic cancer survivors) from a single gastroenterology clinic. 
  • Patients were experiencing persistent, postradiation proctitis with disabling diarrhea, urgency, or fecal incontinence.

Study Design:

This study used a nonrandomized, before-and-after design in which patients served as their own controls.

Measurement Instruments/Methods:

Patients completed questionnaires that assessed severity, frequency, and lifestyle impact of four factors (rectal bleeding, rectal pain, diarrhea, and fecal urgency) with each factor rated on a five point, Likert-type scale ranging from 0–4.

Results:

The majority of patients (14 out of 16) reported less diarrhea, and eight said diarrhea stopped completely. Among patients with rectal bleeding or urgency, symptoms completely resolved in 36% and 19%, respectively. Lifestyle improved in 13 patients, and seven reported a return to normal.

Limitations:

The study is limited because it is nonrandomized and noncontrolled, involves a single clinic, and has a small sample size.

Nursing Implications:

The use of vitamins E and C to manage radiation-induced diarrhea symptoms represents a low risk of harm.


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