PMID- 26541138
OWN - NLM
STAT- MEDLINE
DCOM- 20170425
LR  - 20170425
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 29
IP  - 8
DP  - 2016 Nov
TI  - Effect of baclofen on gastric acid pocket in subjects with gastroesophageal 
      reflux disease symptoms.
PG  - 1054-1063
LID - 10.1111/dote.12443 [doi]
AB  - 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.
CI  - (c) 2015 International Society for Diseases of the Esophagus.
FAU - Scarpellini, E
AU  - Scarpellini E
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
FAU - Boecxstaens, V
AU  - Boecxstaens V
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
FAU - Broers, C
AU  - Broers C
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
FAU - Vos, R
AU  - Vos R
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
FAU - Pauwels, A
AU  - Pauwels A
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
FAU - Tack, J
AU  - Tack J
AD  - TARGID (Translational Research Centre for Gastrointestinal Disorders), University 
      of Leuven, Leuven, Belgium.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20151106
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
RN  - 0 (Muscle Relaxants, Central)
RN  - H789N3FKE8 (Baclofen)
SB  - IM
MH  - Adult
MH  - Baclofen/*therapeutic use
MH  - Double-Blind Method
MH  - Drug Administration Schedule
MH  - Esophageal Sphincter, Lower/drug effects/physiopathology
MH  - Esophagogastric Junction/drug effects/physiopathology
MH  - Female
MH  - Gastric Acid/physiology
MH  - Gastroesophageal Reflux/*drug therapy/physiopathology
MH  - Heartburn/*drug therapy/physiopathology
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Muscle Relaxants, Central/*therapeutic use
MH  - Postprandial Period/drug effects
MH  - Pressure
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - GABA-B receptor
OT  - GERD
OT  - acid pocket
OT  - baclofen
OT  - heartburn
EDAT- 2015/11/07 06:00
MHDA- 2017/04/26 06:00
CRDT- 2015/11/07 06:00
PHST- 2015/11/07 06:00 [pubmed]
PHST- 2017/04/26 06:00 [medline]
PHST- 2015/11/07 06:00 [entrez]
AID - 10.1111/dote.12443 [doi]
PST - ppublish
SO  - Dis Esophagus. 2016 Nov;29(8):1054-1063. doi: 10.1111/dote.12443. Epub 2015 Nov 
      6.