From the Research
Nifedipine (10-30 mg) is the most effective medication for relaxing esophageal contractions, as it significantly reduces lower esophageal sphincter pressure and improves symptoms in patients with achalasia and other primary esophageal motility disorders. Several medications can effectively relax esophageal contractions, which is helpful for conditions like esophageal spasms, achalasia, and diffuse esophageal spasm.
- Calcium channel blockers such as nifedipine and diltiazem are commonly prescribed and work by blocking calcium influx into smooth muscle cells, preventing contraction 1, 2.
- Nitrates like isosorbide dinitrate or nitroglycerin can also be effective by increasing nitric oxide levels, causing smooth muscle relaxation 3, 4.
- For more severe cases, phosphodiesterase-5 inhibitors like sildenafil may be used.
- Anticholinergics such as hyoscyamine reduce acetylcholine's effect on smooth muscle.
- Botulinum toxin injections directly into the lower esophageal sphincter provide relief for 3-6 months by blocking acetylcholine release. These medications are typically taken 15-30 minutes before meals for maximum effectiveness. Side effects vary by medication class but may include headaches, dizziness, low blood pressure, and flushing 1, 2, 5. Treatment duration depends on symptom severity and underlying condition, with some patients requiring long-term therapy while others may use medications only during symptomatic periods 5. However, according to the most recent and highest quality study, nifedipine is the preferred treatment option due to its efficacy in reducing lower esophageal sphincter pressure and improving symptoms 2.