We studied the effects of oral diltiazem (30 mg TII) alone. And combination with diazepam (1 rng Tll) on esophageal manometric chracteristics in 24 patient, with a nucracker esophagus by baseline maotmetry. A 4-week oral administrationn of diltiazem decreased distal esophageal contraction amplitude (205±35.3 mmHg to 150±30.9 mmHg: p<0.01), but had no effect on lower esophageal sphincter pressure and their was poor correlation with chest pain improvement. After 4-week treat- ment with diltiazem and diazepam, contraction amplitude fell from l50±30.9 mmHg to 101±23.4 mmHg (p<0.01) and the relief of symptom was about 90%. This study suggests that diltiazem is demonstrated to result in a reduction of the peristaltic amplitude in patients with nutcrackcr esophagus, but symptomatic benefit is most marked with combination off diazepam.