Esophageal spasms are painful contractions within the muscular tube connecting your mouth and stomach (esophagus). Esophageal spasms can feel like sudden, severe chest pain that lasts from a few minutes to hours. Studies in volunteers and patients with nutcracker esophagus. Richter JE, Spurling TJ, Cordova CM, Castell DO. Animal studies have shown that calcium blocking drugs decrease lower esophageal sphincter pressure and inhibit peristaltic amplitude and duration. Medical therapy 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. Edit concept Create issue ticket Nutcracker Esophagus. Nutcracker esophagus (hypertensive peristalsis) is a condition associated with poor swallowing of both solid and liquid foods due to very high pressures in the esophagus during the swallowing process. Diltiazem therapy for symptoms associated with nutcracker esophagus Article in The American Journal of Gastroenterology 86(3):272-6 · April 1991 with 68 Reads Source: PubMed Cattau EL Jr, Castell DO, Johnson DA, et al. Diltiazem therapy for symptoms associated with nutcracker esophagus. Am J Gastroenterol 1991; 86:272. Am J Gastroenterol 1991; 86:272. Drenth JP, Bos LP, Engels LG. Some studies have shown that long acting calcium channel blockers (i.e. diltiazem) relieves chest pain associated with nutcracker esophagus. Other medications that may have some utility would be trazodone and imipramine. Nutcracker esophagus is characterized by coordinated contractions in the smooth muscle of the esophagus with an excessive amplitude and/or duration. Diffuse esophageal spasm, will have is ≥20 percent premature contractions on esophageal pressure topography. Cattau EL Jr, Castell DO, Johnson DA, et al. Diltiazem therapy for symptoms associated with nutcracker esophagus. Am J Gastroenterol 1991; 86:272–276. Am J Gastroenterol 1991; 86:272–276. Richter JE, Dalton CB, Bradley LA, Castell DO. Nutcracker Esophagus, also known as Hypertensive Peristalsis, is a benign condition and one of the motility disorders of the esophagus where the patient has contractions in the smooth muscles of the esophagus, which occur for excessive duration or amplitude ( 180 mm Hg).