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Nifedipine in the Treatment of Achalasia

KEITH BERGER, M.D.; and RICHARD W. McCALLUM, M.D.
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▸Requests for reprints should be addressed to Richard W. McCallum, M.D.; Gastroenterology Section, 92 LMP, Yale University School of Medicine, 333 Cedar Street; New Haven, CT 06510.


West Haven Veterans Administration Medical Center and Yale University; New Haven, Connecticut.


Ann Intern Med. 1982;96(1):61-62. doi:10.7326/0003-4819-96-1-61
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Nifedipine 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.

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