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Effect of baclofen on gastric acid pocket in subjects with gastroesophageal reflux disease symptoms.
Dis Esophagus. 2016 Nov; 29(8):1054-1063.DE

Abstract

Postprandial gastroesophageal reflux (PGER) in the distal esophagus (DE) is associated with a gastric juice 'acid pocket' (AP). Baclofen reduces AP extension into the DE in healthy volunteers, in part through increased lower esophageal sphincter (LES) pressure. We aimed to verify whether baclofen also affects postprandial AP location and extent in gastroesophageal reflux disease (GERD) patients. Thirteen treatment-naive heartburn-prevalent GERD patients underwent two AP studies, after pretreatment with baclofen 40 mg or placebo 30 minutes preprandially. We performed pH-probe stepwise pull-throughs (PT) (1 cm/min, LES -10 to +5 cm) before and every 30 minutes from 30 minutes before up to 150 minutes after a test meal. After the meal, both after placebo and baclofen, gastric pH significantly dropped at 30, 60, 90 minutes postprandially (P: nadir pHs of 3.9 ± 0.6, 2.3 ± 0.6, 2.1 ± 0.4; B: nadir pHs of 2.5 ± 0.4, 2.8 ± 0.4, 2.5 ± 0.3; all P < 0.05). After placebo, LES pressure decreased at 60, 90 and 120 minutes postprandially (32.7 ± 6.1 vs. 24.5 ± 3.1, 27.3 ± 5.9, 27.3 ± 6.0 mmHg; analysis of variance [ANOVA], P = 0.037), but this was prevented by baclofen (25.4 ± 3.4 vs. 29.4 ± 2, 32.2 ± 1.4, 35.5 ± 1.7 mmHg, ANOVA, P = not significant (NS)). Baclofen did not significantly decrease the postprandial AP extent above the LES but prevented the postprandial increase in transient lower esophageal sphincter relaxations (TLESRs) (preprandial vs. postprandial, placebo: 1.1 ± 0.3 vs. 3.7 ± 0.7, P < 0.05; baclofen: 1.4 ± 0.4 vs. 2 ± 0.5, P = NS). In GERD patients, baclofen significantly increases postprandial LES pressure, prevents the increase TLESRs but, unlike in healthy volunteers, does not affect AP extension into the DE.

Authors+Show Affiliations

TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.TARGID (Translational Research Centre for Gastrointestinal Disorders), University of Leuven, Leuven, Belgium.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26541138

Citation

Scarpellini, E, et al. "Effect of Baclofen On Gastric Acid Pocket in Subjects With Gastroesophageal Reflux Disease Symptoms." Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, vol. 29, no. 8, 2016, pp. 1054-1063.
Scarpellini E, Boecxstaens V, Broers C, et al. Effect of baclofen on gastric acid pocket in subjects with gastroesophageal reflux disease symptoms. Dis Esophagus. 2016;29(8):1054-1063.
Scarpellini, E., Boecxstaens, V., Broers, C., Vos, R., Pauwels, A., & Tack, J. (2016). Effect of baclofen on gastric acid pocket in subjects with gastroesophageal reflux disease symptoms. Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, 29(8), 1054-1063. https://doi.org/10.1111/dote.12443
Scarpellini E, et al. Effect of Baclofen On Gastric Acid Pocket in Subjects With Gastroesophageal Reflux Disease Symptoms. Dis Esophagus. 2016;29(8):1054-1063. PubMed PMID: 26541138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of baclofen on gastric acid pocket in subjects with gastroesophageal reflux disease symptoms. AU - Scarpellini,E, AU - Boecxstaens,V, AU - Broers,C, AU - Vos,R, AU - Pauwels,A, AU - Tack,J, Y1 - 2015/11/06/ PY - 2015/11/7/pubmed PY - 2017/4/26/medline PY - 2015/11/7/entrez KW - GABA-B receptor KW - GERD KW - acid pocket KW - baclofen KW - heartburn SP - 1054 EP - 1063 JF - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus JO - Dis Esophagus VL - 29 IS - 8 N2 - Postprandial gastroesophageal reflux (PGER) in the distal esophagus (DE) is associated with a gastric juice 'acid pocket' (AP). Baclofen reduces AP extension into the DE in healthy volunteers, in part through increased lower esophageal sphincter (LES) pressure. We aimed to verify whether baclofen also affects postprandial AP location and extent in gastroesophageal reflux disease (GERD) patients. Thirteen treatment-naive heartburn-prevalent GERD patients underwent two AP studies, after pretreatment with baclofen 40 mg or placebo 30 minutes preprandially. We performed pH-probe stepwise pull-throughs (PT) (1 cm/min, LES -10 to +5 cm) before and every 30 minutes from 30 minutes before up to 150 minutes after a test meal. After the meal, both after placebo and baclofen, gastric pH significantly dropped at 30, 60, 90 minutes postprandially (P: nadir pHs of 3.9 ± 0.6, 2.3 ± 0.6, 2.1 ± 0.4; B: nadir pHs of 2.5 ± 0.4, 2.8 ± 0.4, 2.5 ± 0.3; all P < 0.05). After placebo, LES pressure decreased at 60, 90 and 120 minutes postprandially (32.7 ± 6.1 vs. 24.5 ± 3.1, 27.3 ± 5.9, 27.3 ± 6.0 mmHg; analysis of variance [ANOVA], P = 0.037), but this was prevented by baclofen (25.4 ± 3.4 vs. 29.4 ± 2, 32.2 ± 1.4, 35.5 ± 1.7 mmHg, ANOVA, P = not significant (NS)). Baclofen did not significantly decrease the postprandial AP extent above the LES but prevented the postprandial increase in transient lower esophageal sphincter relaxations (TLESRs) (preprandial vs. postprandial, placebo: 1.1 ± 0.3 vs. 3.7 ± 0.7, P < 0.05; baclofen: 1.4 ± 0.4 vs. 2 ± 0.5, P = NS). In GERD patients, baclofen significantly increases postprandial LES pressure, prevents the increase TLESRs but, unlike in healthy volunteers, does not affect AP extension into the DE. SN - 1442-2050 UR - https://www.unboundmedicine.com/medline/citation/26541138/Effect_of_baclofen_on_gastric_acid_pocket_in_subjects_with_gastroesophageal_reflux_disease_symptoms_ L2 - https://academic.oup.com/dote/article-lookup/doi/10.1111/dote.12443 DB - PRIME DP - Unbound Medicine ER -