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Type: Journal article
Title: Control of transient lower esophageal sphincter relaxations and reflux by the GABAB agonist Baclofen in normal subjects
Author: Lidums, I.
Lehmann, A.
Checklin, H.
Dent, J.
Holloway, R.
Citation: Gastroenterology, 2000; 118(1):7-13
Publisher: W B Saunders Co
Issue Date: 2000
ISSN: 0016-5085
Abstract: <h4>Background & aims</h4>Transient lower esophageal sphincter (LES) relaxations are the major mechanism of gastroesophageal reflux in normal subjects and in most patients with reflux disease. gamma-Aminobutyric acid (GABA) is an important inhibitory neurotransmitter within the central nervous system which is present in regions of the brainstem that are believed to mediate transient LES relaxations. The aim of this study was to investigate the effect of a GABA(B) agonist baclofen on postprandial gastroesophageal reflux and transient LES relaxations.<h4>Methods</h4>In 20 healthy volunteers, esophageal motility and pH were measured, with the subjects in the sitting position, for 3 hours after a 3000-kJ mixed nutrient meal. On separate days at least 1 week apart, 40 mg oral baclofen or placebo was given 90 minutes before the meal.<h4>Results</h4>Baclofen significantly reduced the rate of reflux episodes by more than 60% from 1.0 (0.3-2.7) to 0.3 (0-1.0) per hour (median [interquartile range]). Baclofen also reduced the rate of transient LES relaxations from 5.7 (4.9-7.8) to 2.2 (1.3-3.8) per hour and increased basal LES pressure from 8.7 +/- 1.4 to 10.8 +/- 0.8 mm Hg.<h4>Conclusions</h4>In normal human subjects, the GABA(B) agonist baclofen significantly inhibits gastroesophageal reflux by inhibition of transient LES relaxations. These findings suggest that GABA(B) agonists may be useful as therapeutic agents for the management of reflux in patients with gastroesophageal reflux disease.
Keywords: Esophagus; Esophagogastric Junction; Humans; Gastroesophageal Reflux; Baclofen; Human Growth Hormone; GABA Agonists; Muscle Relaxants, Central; Statistics, Nonparametric; Double-Blind Method; Deglutition; Peristalsis; Hydrogen-Ion Concentration; Pressure; Adolescent; Adult; Female; Male
RMID: 0001002085
DOI: 10.1016/S0016-5085(00)70408-2
Appears in Collections:Medicine publications

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