Treatment:

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
• Widening (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.

Expectations (prognosis):

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

Complications:

• 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

Calling your health care provider:

Call your health care provider if:

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