Effects of GABA-B agonist baclofen on esophageal motility: Studies using high-resolution manometry.

Abstract

Baclofen inhibits transient lower esophageal sphincter (LES) relaxation. This study aimed to investigate the effect of baclofen on esophageal peristaltic function and contraction reserve in healthy adults using high-resolution manometry (HRM). Fifteen subjects underwent HRM with ten water swallows and five multiple rapid swallows (MRS) 90minutes after oral intake of either baclofen or placebo on separate days at least 1week apart. HRM parameters assessed included esophagogastric junction contractile integral (EGJ-CI), resting LES pressure, 4-second integrated relaxation pressure (IRP-4s), distal contractile integral (DCI), distal latency, peristaltic breaks, resting upper esophageal sphincter (UES) pressure, and contractile response to MRS. Baclofen significantly increased EGJ-CI (P=.007), IRP-4s (P=.003), and LES pressure (P=.004). UES pressure, latency, and DCI were similar between baclofen and placebo (P=.87, P=.84, and P=.54, respectively). There was no difference in contractile response and peristaltic augmentation following MRS between baclofen and placebo (93% vs 100%, P=.30; 53% vs. 73%, P=.26, respectively). Baclofen increases resting LES pressure and EGJ barrier function, but has no effect on primary peristalsis or contraction reserve.