Reflux inhibitors: a new approach for GERD?

Boeckxstaens, Guy E.

doi:10.1016/j.coph.2008.08.005

Cited by 23 publications

(22 citation statements)

References 47 publications

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“…Considering transient lower esophageal sphincter relaxations account for the vast majority of reflux events [5], it is predictable that baclofen may be helpful for refractory GERC by the inhibition of both acid and nonacid reflux. The limited studies have shown that it decreased the frequency of transient lower esophageal sphincter relaxations by 40-60% and acid or non-acid reflux episodes by 43% [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Successful Resolution of Refractory Chronic Cough Induced by Gastroesophageal Reflux With Treatment of Baclofen

Xu¹,

Qiu²,

Lv³

et al. 2012

Chest

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Section: Discussionmentioning

confidence: 99%

Successful Resolution of Refractory Chronic Cough Induced by Gastroesophageal Reflux With Treatment of Baclofen

Xu¹,

Qiu²,

Lv³

et al. 2012

Chest

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“…29 The clinical use of baclofen is, however, limited by its adverse effects on the central nervous system, which include dizziness and somnolence. In a recent proof-of-concept study, the newly developed GABA B receptor agonist lesogaberan, which appears to act predominantly in the periphery, significantly reduced reflux symptoms in patients with GERD with symptoms despite PPI therapy, and was well tolerated.…”

Section: Discussionmentioning

confidence: 99%

“…30 Another potential approach is treatment with a metabotropic glutamate receptor 5 (mGluR5) antagonist, which has been shown to inhibit TLESRs in animal studies. 29 The mGluR5 negative allosteric modulator ADX10059 significantly reduced the number of symptomatic reflux episodes in patients with GERD in clinical trials. 31 However, as with baclofen, clinical use of ADX10059 may be limited by commonly occurring adverse effects on the central nervous system, including dizziness and nausea.…”

Section: Discussionmentioning

confidence: 99%

Systematic review: role of acid, weakly acidic and weakly alkaline reflux in gastro‐oesophageal reflux disease

Boeckxstaens

Smout

2010

Aliment Pharmacol Ther

119

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Aliment Pharmacol Ther 2010; 32: 334–343SummaryBackground The importance of weakly acidic and weakly alkaline reflux in gastro‐oesophageal reflux disease (GERD) is gaining recognition.Aim To quantify the proportions of reflux episodes that are acidic (pH <4), weakly acidic (pH 4–7) and weakly alkaline (pH >7) in adult patients with GERD, and to evaluate their correlation with symptoms.Methods Studies were identified by systematic PubMed and Embase searches. Data are presented as sample‐size weighted means and 95% confidence intervals.Results In patients with GERD taking a proton pump inhibitor (PPI), 80% (76–84%) of reflux episodes were weakly acidic or weakly alkaline and 83% (78–88%) of reflux symptom episodes were associated with weakly acidic or weakly alkaline reflux episodes. In patients with GERD not taking a PPI, 63% (59–67%) of reflux episodes were acidic and 72% (57–87%) of reflux symptom episodes were associated with acid reflux episodes. Six studies presented data separately for weakly alkaline reflux, which accounted for <5% of all reflux episodes, both on and off PPI therapy.Conclusions Weakly acidic reflux underlies the majority of reflux episodes in patients with GERD on PPI therapy, and is the main cause of reflux symptoms occurring despite PPI therapy.

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“…Transient lower oesophageal sphincter relaxations are controlled by a vago-vagal reflex pathway, which is triggered by gastric distention, integrated in the brainstem and induces release of nitric oxide from intrinsic nerves at the LES. [36][37][38] Endocannabinoids can potentially control this vago-vagal reflex pathway at many points as CB1 receptors are expressed on vagal afferents, in the brain stem, on interneurons in the wall of the gastrointestinal tract and on postganglionic fibres innervating smooth muscle in the gastrointestinal tract. [39][40][41][42] In the dog, rimonabant only increased the number of TLESRs, whereas their characteristics and oesophageal motility were unchanged, and this was considered an argument in favour of a central site of action.…”

Section: Discussionmentioning

confidence: 99%