Several treatment options are available for achalasia, but these treatments can't reverse the damages that already took place in the nerves or loss of nerve cells in the esophagus. The treatments are applied to improve the symptoms of Achalasia. The available treatments can only restore peristaltic movements in the esophagus of the patients with achalasia. Through these treatment procedures, the LES muscle is weakened so that they no longer create any barrier to the passage of swallowed foods to the stomach. Here are some commonly adopted treatment procedures for Achalasia.

1. Drug Therapy for Achalasia
Mainly two types of drugs composed of nitrates and calcium channel blockers are recommended 10 -30 minutes before taking a meal to relax the LES muscle. These drugs can decrease symptoms in people with achalasia. Drug therapy is the most common form of treatment for achalasia. However, the effectiveness of the drug therapy diminishes with time and also shows some side effects, such as headache and low BP. Drug therapy is prescribed initially for those patients who are reluctant, panicked or not healthy enough to take mechanical treatments, such as balloon (pneumatic) dilation and myotomy.

2. Balloon (Pneumatic) Dilatation
In this process at first a collapsed balloon is positioned in the LES, it is then inflated rapidly to split the muscle of the LES. This procedure relieves the swallowing trouble in the patients with achalasia. Many patients require more than one balloon dilation for getting sufficient relief. The success rate of balloon dilation is quite fair. With single balloon dilation 60% patients stay fit even after one year and 25% patients stay fit even after 5 years. About 15% patients experience severe chest pain and fever after a session of balloon dilation.

3. Surgery to Treat Achalasia
The surgery involved in achalasia is called Myotomy, in this process the muscle fibers attached with LES are cut to make the LES easy or less obstructive. In one such surgical technique called Heller myotomy, the muscle fibers attached with the LES at the link of the esophagus and the stomach are operated through laparoscopic procedure. Patients are given local anesthesia, and need to stay in hospitals for a maximum period of two days. The success rate of myotomy is remarkable, on an average 80% patients get relief from the symptoms of achalasia and 85% of patients are reported to be leading normal life even after 10 years and 65% are reported to be in fine condition 20 years after the operation.

4. Peroral Endoscopic Myotomy
The most modern introduction in the treatment procedure of achalasia is Peroral endoscopic myotomy or POEM. In this process, an electrical scalpel is passed through the endoscope to make a slit in the inside layer of the esophagus to create a tunnel within the wall of the esophagus. The endoscope is then advanced through the tunnel, and the esophageal muscle fibers are cut using the electrical scalpel device that is passed along with the endoscope. This process is comparatively a very modern introduction in the treatment of achalasia and too few medical experts are accustomed and trained in this process, hence the treatment is not available everywhere.

5. Botulinum toxin Injection
Botulinum toxin injections are used to temporarily relax or paralyze the adjoining nerves in the LES so that the signals that are making LES to contract are not available to the nerve cells in that region. It helps to relieve the obstruction temporarily, thus enabling the patient to eat food without any visible obstruction. A single dose of botulinum toxin injection relieves most of the symptoms of achalasia in 70 to 90 percent of the patients for a period of three months to one year.