[Esophageal motility dysfunction and radioisotopes. Its modification with a calcium channel blocker]

We described the esophageal radionuclide transit (ERT) of a liquid bolus through 5 areas in pharynx, esophagus (3 levels) and gastric fundus before and after the administration of 30 mg of sublingual nifedipine, in 8 normal individuals and 13 patients with different esophageal motor disturbances. The controls and patients were previously studied by esophageal manometry (EM). The results in control individuals were as follows: 1) the total transit time (TTT) was 11.85 +/- 1.13 sec, 2) the time of beginning of gastric filling (GF) was 3.99 +/- 0.65 sec, 3) the residual activity (RA) was 9.53 +/- 4.64%, 4) nifedipine showed a statistically significant increase of the RA. The ERT detected 100% of the achalasic patients with a TTT that was not greater than 40 seconds and a delayed GF. In the classic achalasia patients nifedipine did not produce significant modifications in the ERT. The only case of vigorous achalasia studied showed an adynamic pattern with activity in peaks which improved after the administration of nifedipine. One of the nutcracker esophagus showed a pattern of sequential peaks with a similar response to nifedipine. The sensitivity of the method was 100%, nifedipine seems to be useful in the sense that improves the esophageal transit. Since the ERT as a non-invasive method and has a 100% sensitivity, we propose it as a step previous to EM in the study of esophageal motor disorders.