Achalasia treatment focuses on relaxing or forcing open the valve between the esophagus and stomach (lower esophageal sphincter) so that food and liquid can move more easily through your digestive tract.
Specific treatment depends on your age and the severity of the condition. The options include:
- Balloon dilation. A balloon is inserted into the esophageal sphincter and inflated to enlarge the opening. This outpatient procedure may need to be repeated if the esophageal sphincter doesn't stay open. Some people can go as long as 10 or 15 years before needing repeat balloon dilation.
- Surgery. Mayo surgeons use a minimally invasive procedure (laparoscopic Heller myotomy) to cut the muscle at the lower end of the esophageal sphincter. People who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD). To prevent reflux problems, Mayo surgeons sometimes do a second procedure (fundoplication) during the surgery when the esophageal sphincter muscle is cut. Surgery may be the preferred option for younger people, although research shows it can be effective in older people.
- Botox (botulinum toxin). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscope. Studies indicate that the injections may need to be repeated, and they may make it more difficult to perform surgery later if needed. Mayo specialists usually use Botox only for older adults and those who aren't good candidates for surgery.