Effect of the GABA_B agonist baclofen on symptoms of GERD

The GABA_B agonist baclofen reduces 24 hour gastro-esophageal reflux and increases gastric pH in patients with GERD, finds a research team in the April issue of Gut.

The gamma-aminobutyric acid (GABA_B) agonist baclofen reduces reflux episodes in the first 3 postprandial hours. This occurs in both patients with gastro-esophageal reflux disease (GERD) and in normal controls.

In this study, researchers from Italy assessed acute and chronic administration of baclofen on 24-hour pH metry and symptoms in GERD patients and normal controls.

In the acute study, the team assessed 28 patients with GERD, and none or mild esophagitis at endoscopy. They also assessed 15 controls.

Baclofen or placebo were administered for 24 hours in a double blinded manner.

In the acute study, gastric pH increased significantly in both groups.

Gut

Subjects underwent esophageal and gastric 48-hour pH metry.

In the chronic study, 16 GERD patients received baclofen (10 mg 4 times daily) or placebo for 4 weeks.

The team evaluated 24-hour esophageal pH metry and reflux symptom scores before and after treatment.

In the acute study, researchers found that the number of reflux episodes and percent of time with pH < 4 was significantly lower after baclofen in both GERD patients and controls.

In addition, gastric pH increased significantly in both groups.

In the chronic study, the team found that 4 weeks after initial administration of baclofen, the number of reflux episodes and percentage of time with pH < 4 significantly decreased in all GERD patients.

In addition, symptom scores significantly improved after treatment with baclofen.

Profs. Ciccaglione and Marzio concluded, "The GABA_B agonist baclofen reduces 24 hour gastro-esophageal reflux and increases gastric pH in GERD patients and controls".

"When given for 1 month to GERD patients, baclofen reduces esophageal acid refluxes and significantly improves symptoms."

"Baclofen may be useful in the therapy of GERD."