Non-Cardiovascular Indications for Nitrates
Achalasia is characterized by loss of peristaltic activity and impairment of relaxation of the lower esophageal sphincter. The sphincter is often hypertensive. This results in esophageal spasm, creating most of the symptoms, signs and complications of achalasia. For about 40 years nitrates have been used to achieve symptomatic relief in this condition. The mechanism of action is relaxation of the esophageal smooth muscle, similarly to the effect of nitrates in vascular walls. Nitrates may be used for this indication by inhalation, as sublingual tablets or as oral spray.