Treatment for achalasia associated with high rate of recurrence

Treatment of choice in case of high chance of recurrence is Endoscopic injection of botulinum toxin to sphincter. Botulinum toxin is neurotoxic protein derived from Clostridium botulinum is highly toxic poisonous substance. Very small amount is used for therapeutic purpose. 7 types of toxins are found. It blocks cholinergic nerve ends reducing the cholinergic acetylcholine release causing flaccid paralysis of muscles. Reference: SRB's Manual of Surgery, 6th Edition, page no= 791.