The effect of baclofen on patients with gastroesophageal reflux disease: A prospective, randomized, double-blinded, placebo-controlled study

Transient lower esophageal sphincter relaxations (TLESRs) are rapid and prolonged relaxations of the lower esophageal sphincter (LES) that are not associated with swallowing. They are the mechanism by which most gastroesophageal reflux episodes occur in normal people and in patients with esophagitis. Transient LES relaxations appear to be mediated by a vagovagal reflex initiated by gastric distention. Baclofen is a g-aminobutyric acid (GABA) derivative that inhibits the production of TLESRs by acting as a GABA(B) receptor agonist at one or more loci along the vagovagal reflex arc. Animal and human studies suggest that baclofen decreases the number of reflux events and amount of esophageal acid exposure. Baclofen or another GABA(B) receptor agonist may be clinically useful in treatment of gastroesophageal reflux disease.

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“…In a preliminary communication, Cossentino et al [45] report that baclofen appears to improve symptoms of GERD.…”

Section: Does Baclofen Improve Symptoms Of Reflux?mentioning

confidence: 96%

“…Cossentino et al [45] reported, in abstract form, their results from 21 subjects with positive Johnson-DeMeester scores and symptoms of GERD who were randomly assigned to treatment with baclofen or placebo for 14 days. These patients were taken off all other antireflux medications.…”

Section: Does Baclofen Change the Rates Of Transient Lower Esophagealmentioning

confidence: 99%

Gastroesophageal reflux disease and baclofen: Is there a light at the end of the tunnel?

Wise

Conklin

2004

Curr Gastroenterol Rep

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“…Most neurons in the NTS transmit signals using either glutamate or γ ‐aminobutyric acid (GABA) 24, 25 and inhibitory modulation of vagal afferent firing has been mediated by the GABA B receptor in an in vitro preparation 26 . However, cholecystokinin (CCK), 27 acetylcholine, 28 opioids, 29, 30 nitric oxide (NO) 27 and cannabinoids 31 have also been implicated in this neuronal pathway, and a number of potential agents, including glutamate antagonists, 32 GABA B agonists, 33 cholecystokinin‐A (CCK A ) antagonists, 34 anticholinergic agents, 35 morphine, 29 5‐HT 3 antagonists 36 and NO synthase inhibitors 37 are being investigated as potential inhibitors of TLESRs.…”

Section: Transient Lower Oesophageal Sphincter Relaxation‐reducing Agmentioning

confidence: 99%

“…The GABA B agonist, baclofen has been shown to reduce TLESRs in both animals and healthy volunteers 38, 39 . More recently, baclofen was reported to significantly reduce the incidence of TLESRs over 3 h compared with placebo in two studies of patients with GERD, 40, 41 and the drug has also been shown to improve acid reflux and decrease the number of reflux episodes in patients with GERD 33, 42 . In a recent study of 16 patients with GERD refractory to PPI therapy (persistent symptoms for at least 3 months despite treatment), baclofen significantly decreased the number of duodeno‐gastro‐oesophageal reflux episodes and associated persistent symptoms 43 .…”

Section: Transient Lower Oesophageal Sphincter Relaxation‐reducing Agmentioning

confidence: 99%

New pharmacological agents for the treatment of gastro‐oesophageal reflux disease

Vakil

2004

Aliment Pharmacol Ther

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SUMMARYProton pump inhibitors, which act at the terminal point of acid secretion -the H + , K + -ATPase -are currently the most effective pharmacological treatments available for reflux disease. Despite the efficacy of the proton pump inhibitors, there is still potential for clinical improvement in gastro-oesophageal reflux disease pharmacotherapy. Faster onset of complete acid inhibition and improved duration of efficacy are two potential areas for improvement A number of novel pharmaceutical agents are currently undergoing clinical evaluation for the treatment of gastro-oesophageal reflux disease. These include transient lower oesophageal sphincter relaxation-reducing agents, serotonergic agents/prokinetics, potassium-competitive acid blockers, mucosal protectants, histamine H 3 agonists and anti-gastrin agents. One or more of these drug groups may represent the future medical therapy for gastrooesophageal reflux disease, should they prove effective in the clinical setting. This review summarizes the state of the art with these agents.

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Barrett's esophagus: proton pump inhibitors and chemoprevention II

Richter

Penagini

Pohl

et al. 2011

Annals of the New York Academy of Sciences

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The following on proton pump inhibitors (PPIs) and chemoprevention in relation to Barrett's esophagus includes commentaries on 48-h pH monitoring, pH-impedence, bile acid testing, dyspepsia, long/short segment Barrett's esophagus, nonerosive reflux disease (NERD), functional heartburn, dual-release delivery PPIs, immediate-release PPIs, long-term PPI use, prokinetic agents, obesity, baclofen, nocturnal acid breakthrough, nonsteroidal antiinflammatory drugs (NSAIDs), and new PPIs.

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The effect of baclofen on patients with gastroesophageal reflux disease: A prospective, randomized, double-blinded, placebo-controlled study

Cited by 4 publications

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Gastroesophageal reflux disease and baclofen: Is there a light at the end of the tunnel?

Gastroesophageal reflux disease and baclofen: Is there a light at the end of the tunnel?

New pharmacological agents for the treatment of gastro‐oesophageal reflux disease

Barrett's esophagus: proton pump inhibitors and chemoprevention II

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