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The effect of baclofen on gastro-oesophageal reflux, lower oesophageal sphincter function and reflux symptoms in patients with reflux disease.

Abstract

BACKGROUND

Baclofen decreases gastro-oesophageal reflux episodes in healthy subjects by reducing the incidence of transient lower oesophageal sphincter relaxations.

AIM

To investigate the effect of baclofen on reflux symptoms, oesophageal pH and lower oesophageal sphincter manometry in patients with gastro-oesophageal reflux disease.

METHODS

A double-blind, placebo-controlled, two-way crossover design was used to study the effect of baclofen on heartburn and regurgitation 3 h after a provocation test meal in 37 patients with gastro-oesophageal reflux disease. Additionally, in 20 of these patients, the effect of baclofen on oesophageal pH, transient lower oesophageal sphincter relaxations and basal lower oesophageal sphincter pressure was studied.

RESULTS

Baclofen significantly decreased the acid reflux time and the incidence of gastro-oesophageal reflux episodes (8.3 +/- 8.8% vs. 12.4 +/- 12.0%, P = 0.03 and 10.9 +/- 7.3 per 3 h vs. 18.7 +/- 12.4 per 3 h). The incidence of transient lower oesophageal sphincter relaxations was significantly lower with baclofen than with placebo (15.1 +/- 6.4 per 3 h vs. 22.8 +/- 5.4 per 3 h, P < 0.0001). Lower oesophageal sphincter pressure and the percentage of transient lower oesophageal sphincter relaxations associated with reflux were not affected by baclofen. No significant effect on symptom scores was observed.

CONCLUSIONS

Baclofen decreases post-prandial acid reflux in patients with gastro-oesophageal reflux disease by reducing the incidence of transient lower oesophageal sphincter relaxations. No effect of a single dose of baclofen on reflux symptoms could be demonstrated in this 3-h post-prandial study.

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  • Authors+Show Affiliations

    ,

    Gastrointestinal Research Unit, Department of Gastroenterology, University Medical Center Utrecht, The Netherlands. M.VANHERWAARDEN@ZONNET.NL

    , ,

    Source

    MeSH

    Adult
    Baclofen
    Cross-Over Studies
    Double-Blind Method
    Esophagogastric Junction
    Female
    Gastroesophageal Reflux
    Gastrointestinal Agents
    Humans
    Hydrogen-Ion Concentration
    Male
    Manometry
    Middle Aged
    Postprandial Period
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12197845

    Citation

    van Herwaarden, M A., et al. "The Effect of Baclofen On Gastro-oesophageal Reflux, Lower Oesophageal Sphincter Function and Reflux Symptoms in Patients With Reflux Disease." Alimentary Pharmacology & Therapeutics, vol. 16, no. 9, 2002, pp. 1655-62.
    van Herwaarden MA, Samsom M, Rydholm H, et al. The effect of baclofen on gastro-oesophageal reflux, lower oesophageal sphincter function and reflux symptoms in patients with reflux disease. Aliment Pharmacol Ther. 2002;16(9):1655-62.
    van Herwaarden, M. A., Samsom, M., Rydholm, H., & Smout, A. J. (2002). The effect of baclofen on gastro-oesophageal reflux, lower oesophageal sphincter function and reflux symptoms in patients with reflux disease. Alimentary Pharmacology & Therapeutics, 16(9), pp. 1655-62.
    van Herwaarden MA, et al. The Effect of Baclofen On Gastro-oesophageal Reflux, Lower Oesophageal Sphincter Function and Reflux Symptoms in Patients With Reflux Disease. Aliment Pharmacol Ther. 2002;16(9):1655-62. PubMed PMID: 12197845.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of baclofen on gastro-oesophageal reflux, lower oesophageal sphincter function and reflux symptoms in patients with reflux disease. AU - van Herwaarden,M A, AU - Samsom,M, AU - Rydholm,H, AU - Smout,A J P M, PY - 2002/8/29/pubmed PY - 2003/1/23/medline PY - 2002/8/29/entrez SP - 1655 EP - 62 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 16 IS - 9 N2 - BACKGROUND: Baclofen decreases gastro-oesophageal reflux episodes in healthy subjects by reducing the incidence of transient lower oesophageal sphincter relaxations. AIM: To investigate the effect of baclofen on reflux symptoms, oesophageal pH and lower oesophageal sphincter manometry in patients with gastro-oesophageal reflux disease. METHODS: A double-blind, placebo-controlled, two-way crossover design was used to study the effect of baclofen on heartburn and regurgitation 3 h after a provocation test meal in 37 patients with gastro-oesophageal reflux disease. Additionally, in 20 of these patients, the effect of baclofen on oesophageal pH, transient lower oesophageal sphincter relaxations and basal lower oesophageal sphincter pressure was studied. RESULTS: Baclofen significantly decreased the acid reflux time and the incidence of gastro-oesophageal reflux episodes (8.3 +/- 8.8% vs. 12.4 +/- 12.0%, P = 0.03 and 10.9 +/- 7.3 per 3 h vs. 18.7 +/- 12.4 per 3 h). The incidence of transient lower oesophageal sphincter relaxations was significantly lower with baclofen than with placebo (15.1 +/- 6.4 per 3 h vs. 22.8 +/- 5.4 per 3 h, P < 0.0001). Lower oesophageal sphincter pressure and the percentage of transient lower oesophageal sphincter relaxations associated with reflux were not affected by baclofen. No significant effect on symptom scores was observed. CONCLUSIONS: Baclofen decreases post-prandial acid reflux in patients with gastro-oesophageal reflux disease by reducing the incidence of transient lower oesophageal sphincter relaxations. No effect of a single dose of baclofen on reflux symptoms could be demonstrated in this 3-h post-prandial study. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/12197845/The_effect_of_baclofen_on_gastro_oesophageal_reflux_lower_oesophageal_sphincter_function_and_reflux_symptoms_in_patients_with_reflux_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0269-2813&amp;date=2002&amp;volume=16&amp;issue=9&amp;spage=1655 DB - PRIME DP - Unbound Medicine ER -