The approach to treatment is to reduce the pressure at the lower esophageal sphincter. Therapy may involve:

• Injection with botulinum toxin (Botox). This may help relax the sphincter muscles, but any benefit wears off within a matter of weeks or months.
• Medications, such as long-acting nitrates or calcium channel blockers, which can be used to relax the lower esophagus sphincter.
• Surgery (called an esophagomyotomy), which may be needed to decrease the pressure in the lower sphincter.
• Wideling (dilation) of the esophagus at the location of the narrowing (done during esophagogastroduodenoscopy).

Your doctor can help you decide which treatment is best for your situation.

The outcomes of surgery and nonsurgical treatments are similar. Sometimes more than one treatment is necessary.

• Backflow (regurgitation) of acid or food from the stomach into the esophagus (reflux)
• Breathing food contents into the lungs, which can cause pneumonia
• Tearing (perforation) of the esophagus

Call your health care provider if:

• You have difficulty swallowing or painful swallowing
• Your symptoms continue even with treatment for achalasia