Effects of oral calcium blocker, diltiazem, on esophageal contractions

Richter, Joel E.; Spurling, Timothy J.; Cordova, Carmel M.; Castell, Donald O.

doi:10.1007/bf01347298

Cited by 108 publications

(6 citation statements)

References 20 publications

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“…In an open label study of 10 patients with nutcracker esophagus, diltiazem 90 mg qid showed improvement (33). However, in a 10 week randomized, double blind cross-over study of 8 patients with diffuse esophageal spasm, diltiazem was not superior to placebo (34).…”

Section: Resultsmentioning

confidence: 99%

Treatment of Esophageal (Noncardiac) Chest Pain: An Expert Review

Coss‐Adame

Erdoğan

Rao

2014

Clinical Gastroenterology and Hepatology

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Objectives Chest pain is a common and frightening symptom. Once cardiac disease has been excluded, an esophageal source is most likely. Pathophysiologically, gastroesophageal reflux disease (GERD), esophageal dysmotility, esophageal hypersensitivity and anxiety disorders have been implicated. Treatment however remains a challenge. Here, we examined the efficacy and safety of various commonly used modalities for treatment of esophageal (non-cardiac) chest pain (ECP) and provided evidence-based recommendations. Methods We reviewed the English literature for drug trials evaluating treatment of ECP in PUBMED, COCHRANE and MEDLINE databases from 1968 to 2012. Standard forms were used to abstract data regarding study design, duration, outcome measures and adverse events and study quality. Results Thirty five studies comprising of various treatments were included and grouped under five broad catagories. Patient inclusion criteria were extremely variable and studies were generally small with methodological concerns. There was good evidence to support the use of omeprazole, and fair evidence for lansoprazole, rabeprazole, theophylline, sertraline, trazodone, venlafaxine, imipramine and cognitive behavioral therapy (CBT). There was poor evidence for nifedipine, diltiazem, paroxetine, biofeedback therapy, ranitidine, nitrates, botulinum toxin, esophageal myotomy and hypnotherapy. Conclusions Ideally, treatment of ECP should be aimed at correcting the underlying mechanism(s) and relieving symptoms. PPIs, antidepressants, theophylline and CBT appear to be useful for the treatment of ECP. However, there is urgent and unmet need for effective treatments and for rigorous, randomized controlled trials.

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Section: Resultsmentioning

confidence: 99%

Treatment of Esophageal (Noncardiac) Chest Pain: An Expert Review

Coss‐Adame

Erdoğan

Rao

2014

Clinical Gastroenterology and Hepatology

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“…Diltiazem, a calcium channel blocker, is a proven treatment of excessive contraction in the esophageal and associated symptoms [13]. After a combination of dilation of the sleeve, to prevent possible sleeve twisting, and prescription of diltiazem, symptoms in our patient completely resolved.…”

Section: Discussionmentioning

confidence: 79%

High-Amplitude Gastric Contractions following Laparoscopic Sleeve Gastrectomy

Zhou

Jameson

2019

Case Reports in Surgery

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A proportion of laparoscopic sleeve gastrectomy patients experience symptoms of regurgitation and epigastric pain postoperation. The appearance of gastric sleeve contractions has been documented but its implications have not been adequately investigated. This case describes a 61-year-old female following laparoscopic sleeve gastrectomy. The patient underwent high-resolution impedance esophageal manometry that identified compartmentalized pressurization leading to propagating contractions throughout the gastric sleeve. Combined treatment with calcium channel blockers and gastric sleeve dilation relieved all symptoms. This case highlights the application of high-resolution impedance esophageal manometry to assess motor function and bolus transit in patients following laparoscopic sleeve gastrectomy.

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“…When nifedipine was used to treat different dysmotility disorders, patients with diffuse esophageal spasm, achalasia, and nutcracker esophagus reportedly showed a significant decrease in the LES pressure and amplitude [36, 39, 40]. Verapamil is another CCB that has been reported to decrease the LES pressure when used in both oral and intravenous forms [41, 42]. However, the available evidence above supports that this group of medications relieves esophageal motility symptoms but currently no existent guidelines to suggest routine use of CCB in the acute management of esophageal impaction.…”

Section: Management Options Of Impacted Food Bolusmentioning

confidence: 99%

Pharmacological Management of Esophageal Food Bolus Impaction

Khayyat

2013

Emergency Medicine International

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Background. Soft esophageal bolus impaction is an emergency that requires skilled endoscopic removal if persistent obstructive symptoms do not resolve spontaneously after careful observation. Expedited care of these patients is crucial to avoid respiratory and mechanical complications. Other possible options for management include medical agents used to manage it prior to performing endoscopy if access to endoscopy was not available or declined by the patient. Aim. To review the available pharmacological and other nonmedicinal options and their mechanism of relief for soft esophageal impaction. Method. Pubmed, Medline and Ovid were used for search of MESH terms pertinent including “foreign body, esophageal, esophageal bolus and medical” for pharmacological and non medicinial agents used for management of esophageal soft bolus impaction as well as manual review of the cross-references. Results. Several agents were identified including Buscopan, Glucagon, nitrates, calcium channel blockers, and papaveretum. Non medicinal agents are water, effervescent agents, and papain. No evidence was found to suggest preference or effectiveness of use of a certain pharmacological agent compared to others. Buscopan, Glucagon, benzodiazepines, and nitrates were studied extensively and may be used in selected patients with caution. Use of papain is obsolete in management of soft bolus impaction.

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Effects of oral calcium blocker, diltiazem, on esophageal contractions

Cited by 108 publications

References 20 publications

Treatment of Esophageal (Noncardiac) Chest Pain: An Expert Review

Treatment of Esophageal (Noncardiac) Chest Pain: An Expert Review

High-Amplitude Gastric Contractions following Laparoscopic Sleeve Gastrectomy

Pharmacological Management of Esophageal Food Bolus Impaction

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