Original article—alimentary tractBaclofen Improves Symptoms and Reduces Postprandial Flow Events in Patients With Rumination and Supragastric Belching
Section snippets
Patients
We studied 16 patients (10 women; mean age, 43 years; range, 18–89 years) with a clinical suspicion of rumination. All patients had undergone upper gastrointestinal endoscopy and empiric proton pump inhibitor (PPI) and prokinetic therapy without clear explanation of the symptoms and without beneficial symptomatic effect.
Study Protocol
All patients underwent stationary high-resolution manometry (HRM)-impedance recordings after an overnight fast. The manometry-impedance assembly (Medical Measurement Systems,
Results
Twelve patients (8 women; mean age, 45 years; range, 18–89 years) were included in the final analysis. Four patients were excluded from the study because they refused the second HRM-impedance recording while on baclofen. Ten patients presented with predominant symptoms of regurgitation, whereas 2 patients presented with predominant symptoms of belching.
Four of the 12 patients included in the final analysis reported side effects of sleepiness and difficulty to concentrate during baclofen
Discussion
The GABAB agonist baclofen has been shown to increase the basal LES pressure and to reduce the number of TLESRs, resulting in reduction of acid and nonacid reflux in GERD patients.10, 11, 12, 13 The increase in LES function might be potentially beneficial in patients with rumination syndrome because it might increase the threshold to induce upward movement of liquid gastric contents or gas into the esophagus during straining. In addition to an improved LES function, baclofen decreases the
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2022, GastroenterologyCitation Excerpt :Several studies using this procedure have provided evidence that the ROME diagnostic criteria perform adequately. For example, in a cohort study evaluating the use of baclofen, 8 of 10 patients with predominant rumination syndrome symptoms according to the Rome III criteria displayed a rumination pattern on combined postprandial impedance manometry.52 In another controlled clinical trial with baclofen, which included 21 subjects who fulfilled the Rome IV criteria for rumination syndrome, esophageal impedance manometry with postprandial registration confirmed the diagnosis of rumination syndrome in all.53
Rumination syndrome: Critical review
2022, Gastroenterologia y HepatologiaRumination syndrome. A review article
2021, Revista de Gastroenterologia de Mexico
Conflicts of interest The authors disclose no conflicts.
Funding Drs Blondeau and Farré receive funding from the FWO Flanders. This study was funded by a Methusalem grant from Leuven University to Prof Tack.