How is tx of achalasia?

Non surgical (medications [CCB, Nitrates], hydrostatic dilatation [balloon dilates lower esophagus 60% relief, 10% second dilation, good long term results], Botulinum toxin [lower esophagus relaxation]) Surgical (Heller myotomy [relieves dysphagia 80-90%], Esophagectomy [if megaesophagus, failure of myotomy, reflux stricture undilated)