Nitrates for achalasia.

BACKGROUND

Achalasia is a disease that impairs oesophageal motility. Though nitrates have been used to treat achalasia for a long time, the effectiveness of nitrates for achalasia is still controversial.

OBJECTIVES

To quantify short-term and long-term effects of nitrate therapy in patients with achalasia.

SEARCH STRATEGY

Trials were identified by searching the Cochrane Controlled Trials Register (Issue 4-2001), MEDLINE (1966-2001), EMBASE (1980-2001), LILACS - Latin American and Caribbean health science literature (1982-2001) and CBM-Chinese Biomedical database(1980-2000). Additionally, all references in the identified trials were checked for further relevant trials. An updated search was run on the Cochrane Library, MEDLINE, and EMBASE in September 2003 - no new trials were found.

SELECTION CRITERIA

All randomised controlled trials involving achalasic patients given any type of nitrates were included.

DATA COLLECTION AND ANALYSIS

Data were extracted by two independent observers based on the intention to treat principle.

MAIN RESULTS

Two randomised cross-over studies were found, but no results are included. Due to the design of the studies and the method of reporting the results in the original paper it was not possible to extract the necessary information to examine any of the outcomes.

REVIEWER'S CONCLUSIONS: We can conclude no implications for practice at this stage. Appropriately designed parallel group randomised controlled trials with long term follow-up are needed to determine the effects of nitrates.