Control of esophageal distension-induced secondary peristalsis by the GABAB agonist baclofen in humans

Abstract

This study provides an evidence for inhibitory modulation of esophageal secondary peristalsis by the GABA(B) agonist baclofen. Activation of secondary peristalsis is probably modulated by GABA(B) receptors; however, baclofen does not lead to any motility change in secondary peristalsis.

Gamma‐aminobutyric acid receptor type B agonist baclofen inhibits acid‐induced excitation of secondary peristalsis but not heartburn sensation

“…In agreement with prior studies, it may be argued that baclofen is of utility in treating GERD in that it can reduce esophageal mechanosensitivity in response to acid‐induced excitation of secondary peristalsis. Although baclofen has been recommended as a therapeutic alternate in refractory GERD, our findings support previous notion in justifying careful use of GABA‐B receptors agonists in treating reflux disease in view of their potentially negative impact on secondary peristalsis, especially in conditions with significant erosive GERD who may have more defective secondary peristalsis …”

“…In human esophagus, GABA‐B receptor agonist baclofen inhibits esophageal mechanosensitivity of distension‐induced secondary peristalsis . In this study, we further demonstrated that distension thresholds of secondary peristalsis during slow and rapid air injections after acid infusion were also attenuated by baclofen.…”

“…GABA‐B receptors agonist, baclofen, has been well known for its pharmacological utility in the inhibition of transient lower esophageal sphincter relaxations in animal and human models . In human esophagus GABA‐B receptor agonist baclofen, a single 40‐mg dose orally inhibits mechanosensitivity of distension‐induced secondary peristalsis in human esophagus …”

Practical aspects of high resolution esophageal manometry

“…The characteristics of secondary peristalsis are well known (88,89) and can be easily seen with HRM; however, they are not covered by the CCH. They are defined as peristaltic contractions that are not preceded by swallowing, that respond to the stimulation of mechanoreceptors and/ or chemoreceptors of the esophageal wall and the aim of which is to "cleanse" the esophageal body content.…”

Effects of GABA‐B agonist baclofen on esophageal motility: Studies using high‐resolution manometry

“…Although the effects of baclofen on esophageal peristalsis have been studied using conventional esophageal manometry, limited data are available using HRM, especially using provocative testing with MRS. Therefore, the aim of this study was to characterize the effects of baclofen on esophageal primary peristalsis and contraction reserve in healthy volunteers using HRM.…”