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Medications for nutcracker esophagus includes the use of calcium-channel blockers, which relax the lower esophageal sphincter (LES) and palliate the dysphagia symptoms. Diltiazem, a calcium-channel blocker, has been used in randomized control studies with good effect.
Caffeine can relax the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus. ... and anti-cholinergic medications, may weaken the lower esophageal sphincter ...
Esophageal achalasia, often referred to simply as achalasia, is a failure of smooth muscle fibers to relax, which can cause the lower esophageal sphincter to remain closed. Without a modifier, "achalasia" usually refers to achalasia of the esophagus .
Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain. [6] HLES (hypertensive lower esophageal sphincter) is a rare manometric abnormality seen among individuals with dysphagia, chest pain, gastroesophageal reflux, and hiatal hernia. [7]
Nifedipine, in small doses (2x 5 mg per day, 10 mg per day in slow release or as much as the blood pressure allows it), can be prescribed in an attempt to provide a first relief, by blocking the esophageal spasms that may be involved and reduce the reflux going up to the throat. Muscle relaxants (benefit obtained on the short-term)
Esophageal spasm is a disorder of motility of the esophagus. [2] There are two types of esophageal spasm: [2] Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions; Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude.
Sucralfate, sold under various brand names, is a medication used to treat stomach ulcers, gastroesophageal reflux disease (GERD), radiation proctitis, and stomach inflammation and to prevent stress ulcers. [3] [4] [5] Its usefulness in people infected by H. pylori is limited. [3]
For reflux esophagitis, a fundooplication can be done to help strengthen the lower esophageal sphincter from allowing backflow of the stomach into the esophagus. For esophageal stricture, a gastroenterologist can perform a dilation of the esophagus. As of 2020 evidence for magnetic sphincter augmentation is poor. [11]
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