Baclofen in Refractory Dyspepsia With Chronic Belching: A Case Report

Dyspeptic symptoms associated with chronic belching may substantially affect quality of life and can be challenging to manage in clinical practice. We report the case of a 40-year-old nulligravid woman with depressive disorder, bilateral cochlear implants due to deafness, a hiatal hernia, and a previous pulmonary embolism. Her medications included desvenlafaxine, multiple benzodiazepines, mirtazapine, trazodone, and apixaban. She presented with an 18-month history of persistent belching, heartburn, early satiety, and intermittent dry cough, severely impairing her quality of life and leading to social isolation. Additionally, her symptoms intensified during anxiety and depressive episodes. Physical examination was unremarkable, and upper gastrointestinal endoscopy revealed only a small hiatal hernia and mild gastropathy, with no evidence of Helicobacter pylori infection. Despite repeated medical evaluations and multiple therapeutic approaches, including proton pump inhibitors, sucralfate, domperidone, simethicone, and bilastine, symptoms persisted without significant improvement. Functional dyspepsia was therefore suspected, and treatment with baclofen 10 mg twice daily was initiated, resulting in significant clinical improvement and enhanced quality of life. This report highlights the potential benefit of baclofen in patients with persistent belching and dyspeptic symptoms refractory to conventional therapy, particularly in the context of psychiatric comorbidity.