Efficacy of Adding Baclofen to Treat Patients with Non-Erosive Reflux Disease Resistant to Treatment

Non-erosive reflux disease (NERD) is one of the categories of gastro-esophageal reflux disease defined as the presence of classic reflux symptoms in the absence of esophageal mucosal injury during upper endoscopy. The efficacy of proton pump inhibitor (PPI) is observed in these patients and it is demonstrated that the proportion of them respond to a standard dose of proton pump inhibitors lower than patients with erosive esophagitis. Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has been shown to reduce transient lower esophageal sphincter relaxations (TLESRs), a major cause of gastro-esophageal reflux disease. This study aimed to investigate the efficacy of adding baclofen to treat patients with non-erosive reflux disease resistant to proton-pump-inhibitor treatment. Ninety patients with non-erosive reflux disease resistant to treatment with proton pump inhibitor were randomly divided into two groups. The first group received baclofen (20 mg per day) plus omeprazole (20 mg per day) and the second group received only omeprazole (20 mg per day). After 2 months, the findings were compared. Differences in age, sex, weight, previous treatment with proton pump inhibitor, existence of hiatal hernia and previous treatment of Helicobacter pylori were not significant between the groups. Patients receiving baclofen plus omeprazole had significantly less heart burn (P = 0.014), regurgitation (P = 0.012), sour taste (P = 0.029) and belching (P = 0.001). The data suggest that baclofen plus omeprazole have additive effects in treatment of patients with non-erosive reflux disease.