Hi, I have gone through your question and understand your concerns. In Achalasia basically there is loss of relaxation of sphincter at esophagus and stomach joint and due to that food stays in esophagus for prolong period of time and that can have complications like : Aspiration pneumonia ,Esophagitis,Perforation of Esophagus and rarely esophageal cancer. The goal of therapy for achalasia is to relieve symptoms by eliminating the outflow resistance caused by the hypertensive and nonrelaxing LES. You can use pharmacological treatment initially: Administration of calcium channel blockers and nitrates decrease LES pressure (primarily in elderly patients who cannot undergo pneumatic dilatation or surgery) Endoscopic intrasphincteric injection of botulinum toxin to block acetylcholine release at the level of the LES (mainly in elderly patients who are poor candidates for dilatation or surgery) Surgical Can also be performed. Patients in whom surgery fails may be treated with an endoscopic dilatation first. If this fails, a second operation can be attempted once the cause of failure has been identified with imaging studies. Esophagectomy is the last resort. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate to ask. I will be happy to answer your questions. Wishing you good health.