Baclofen Treatment for Aerophagia

Clinical Evidence and Guidelines

• The American Gastroenterological Association recognizes baclofen as a treatment option for belching disorders, particularly when related to supragastric belching and aerophagia 1
• Aerophagia should be suspected when manometry shows influx of air into the esophagus with swallowing, causing intestinal gas accumulation visible on abdominal X-rays 1
• To differentiate types of belching (which may be related to aerophagia), ambulatory impedance monitoring with or without high-resolution manometry is recommended, with 24-hour impedance being preferred 1

Dosing and Administration

• The Clinical Gastroenterology and Hepatology society recommends baclofen for regurgitation or belch-predominant symptoms in GERD management 2
• Starting with a low dose and gradually increasing is recommended to minimize common side effects such as dizziness, somnolence, and gastrointestinal discomfort 2
• Common side effects of baclofen include dizziness, somnolence, and gastrointestinal symptoms 2

Baclofen Therapy for Aerophagia

Potential Side Effects and Precautions

• The American Geriatrics Society notes that baclofen can cause common side effects including dizziness, somnolence, and gastrointestinal discomfort, particularly in elderly patients or those with impaired renal function 3
• Baclofen may inhibit swallowing function through central mechanisms and can cause significant central nervous system effects, so caution is advised when prescribing to patients with existing swallowing difficulties or impaired renal function, and abrupt discontinuation should be avoided due to potential withdrawal symptoms 3
• The Anaesthesia society recommends that abrupt discontinuation of baclofen should be avoided due to potential withdrawal symptoms, particularly in patients who have been on higher doses for extended periods 4