Nifedipine in the Treatment of Achalasia
Authors: KEITH BERGER
Journal: Annals of Internal Medicine (1982)

Brief Reports1 January 1982Nifedipine in the Treatment of AchalasiaKEITH BERGER, M.D., RICHARD W. McCALLUM, M.D.KEITH BERGER, M.D.Search for more papers by this author, RICHARD W. McCALLUM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-1-61 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNifedipine acts by inhibiting the slow transmembrane calcium flux responsible for electromechanical coupling in cardiac and smooth muscle (1, 2). Clinical trials have shown nifedipine to be effective and safe in treating coronary vasospasm (3-5). A European study suggests that nifedipine improves smooth muscle function in esophageal motility disorders, such as achalasia and diffuse esophageal spasm (6). We report the case of a patient with "vigorous" achalasia, who, refractory to all medical therapy, had a dramatic subjective and objective response to oral nifedipine.The patient is a 63-year-old white man with a well-documented and long-standing history of atherosclerotic cardiovascular disease....References1. FLEKENSTEIN A. On the basic pharmacological mechanism of nifedipine and its relation to therapeutic efficacy. In: JATENE A, LICHTLEN P, eds. Third International Adalat Symposium. New Therapy of Ischemic Heart Disease. Amsterdam, Oxford: Excerpta Medica; 1976:1-13. Google Scholar2. ADELSTEIN R and HATHAWAY D. Role of calcium and cyclic adenosine 3′:5′ monophosphate in regulating smooth muscle contraction: mechanisms of excitation-contraction coupling in smooth muscle. Am J Cardiol. 1979;44:783-7. CrossrefMedlineGoogle Scholar3. MULLER J and GUNTHER S. Nifedipine therapy for Prinzmental's angina. Circulation. 1978;57:137-9. CrossrefMedlineGoogle Scholar4. HEUPLER F and PROUDFIT W. Nifedipine therapy for refractory coronary arterial spasm. Am J Cardiol. 1979;44:798-803. CrossrefMedlineGoogle Scholar5. ANTMAN E, MULLER J, and GOLDBERG S. Nifedipine therapy for coronary artery spasm: experience in 127 patients. N Engl J Med. 1980;302:1269-73. CrossrefMedlineGoogle Scholar6. WEISER H, LEPSIEN G, GOLENHOFEN K, and SIEWERT R. Clinical and experimental studies on the effect of nifedipine on smooth muscle on the oesophagus and lower esophageal sphincter. In: DUTHIE H, ed. Gastrointestinal Motility in Health and Disease. Lancaster: MTP Press Limited; 1978:565-72. CrossrefGoogle Scholar7. SANDERSON D, ELLIS F, and SCHLEGEL J. Syndrome of vigorous achalasia: clinical and physiologic observations. Chest. 1967;52:508-17. Google Scholar8. KROSIN G, SALADINO T, and MCCALLUM R. Radionuclide quantitation of esophageal emptying of solid food in achalasia. Gastroenterology. 1980;78:1201. Abstract. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KEITH BERGER, M.D.; RICHARD W. McCALLUM, M.D.Affiliations: West Haven Veterans Administration Medical Center and Yale University New Haven, Connecticut. 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