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June 1988

Nifedipine in the Treatment of Distal Esophageal Food Impaction

Arch Otolaryngol Head Neck Surg. 1988;114(6):682-683. doi:10.1001/archotol.1988.01860180096052

To the Editor.—Distal esophageal food impaction is a difficult condition to treat. Generally, an otolaryngologist will address this problem by direct visualization with rigid endoscopy, since flexible endoscopy and other radiologically controlled techniques can significantly endanger the airway. The tedious task of removing a soft distal impaction with forceps is accompanied by the risk of anesthesia and the potential for esophageal perforation. A medical solution to this problem may be helpful in selected

Nifedipine (Procardia) is a calcium channel blocker designed for the treatment of angina. Gastroenterologists have also found nifedipine useful in patients with esophageal spasm and achalasia.1,2 These studies indicate that nifedipine significantly reduces lower esophageal sphincter (LES) pressure and the amplitude of LES contractions, without changing contraction amplitudes in the body of the esophagus. Lower esophageal sphincter selective sensitivity to nifedipine may be due to the circular arrangement of smooth-muscle fibers that relax on calcium