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Title: Baclofen Improves Symptoms and Reduces Postprandial Flow Events in Patients with Rumination and Supragastric Belching
Authors: Blondeau, Kathleen ×
Boecxstaens, Veerle
Rommel, Nathalie
Farre, Ricard
Depeyper, Stephanie
Holvoet, L
Boeckxstaens, Guy
Tack, Jan #
Issue Date: Apr-2012
Publisher: W.B. Saunders for the American Gastroenterological Association
Series Title: Clinical Gastroenterology and Hepatology vol:10 issue:4 pages:379-384
Abstract: BACKGROUND & AIMS: In patients with clinically suspected rumination, esophageal impedance manometry differentiates episodes of rumination (involuntary straining with intragastric pressure rises) from aerophagia/supragastric belching. Treatment options are limited and focused on behavioral therapy. Baclofen, an agonist of theā–”- -aminobutyric acid (GABA) B receptor, increases lower-esophageal sphincter pressure and decreases swallowing rate; we investigated its effects in these patients. METHODS: High resolution manometry-impedance recordings were taken from 12 patients (8 women, mean age 45 [range, 18-89] years) with clinically suspected rumination or supragastric belching, before and during treatment with baclofen (10 mg, 3 times daily). After 30 minutes of recordings, patients received a 1000 kcal solid meal; recordings were then continued for 1h. Patients were asked to register symptoms with an event marker. The number of symptoms registered and number and type of flow events were compared before and during treatment. RESULTS: An average of 20 (range, 14-34) symptom markers were recorded at baseline (10 [range, 4-25] for belching and 9 [range,0-11] for regurgitation); this was significantly reduced to 6 (range, 2-22) (3 [range, 1-15] for belching and 1 [range, 0-13] for regurgitation) during baclofen treatment (P =.01). The number of flow events (473 at baseline [42 reflux, 192 rumination, 188 supragastric belching, and 42 aerophagia], was significantly reduced to 282 (32 reflux, 99 rumination, 123 supragastric belching, and 13 aerophagia) during baclofen therapy (P =.02). The reduction in flow events correlated with the increase in LES pressure (r =-.62; P =.03) and reduction in swallowing frequency (r=.64; P =.02). CONCLUSION: Baclofen is an effective treatment for patients with rumination or supragastric belching/aerophagia.
ISSN: 1542-3565
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Translational Research in GastroIntestinal Disorders
Research Group Experimental Oto-rhino-laryngology
× corresponding author
# (joint) last author

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