Achalasia Treatment

Medicines. These are given only while more definitive treatment is being carried out, as they have a limited response. Among them are muscle relaxants, such as calcium antagonists and nitrates, which are used to relax the oesophageal sphincter before eating, thus allowing food to enter the stomach. As a side effect, they can lower blood pressure and cause headaches. 

Botulinum toxin. This is administered into the oesophageal sphincter via an endoscopic needle where Botox relaxes the sphincter fibres so it can open and allow food to enter the stomach. It lasts between 6 months and a year, so it must be administered again after this time. It is administered to those patients in whom definitive treatment may pose a risk due to their general health status.

Pneumatic dilation. Using endoscopy and sedation, a balloon is inserted and inflated to dilate and disrupt some of the oesophageal sphincter fibres. One in three people have to have this procedure repeated after 5 years.  

Heller Myotomy. The difference with POEM is that this treatment involves laparoscopic surgery. The procedure is usually completed with a fundoplication to prevent possible stomach reflux. Here, the surgeon surrounds the lower part of the oesophagus with stomach tissue to create an anti-reflux valve.