Heller's myotomy is done for:

Ans. b. AchalasiaRef: Bailey and Loves Short Practice of Surgery 27th Ed; Page No-1098ACHALASIAMotility disorder of the esophagus characterized by impaired relaxation of the lower esophageal sphincter (LES) and loss of peristalsis in the distal two-thirds of the esophagus.Etiology: Degeneration of the inhibitory neurons in the myenteric (Auerbach) plexus.HISTORY/PEProgressive dysphagia (solids and liquids), chest pain, regurgitation of undigested food, weight loss, and nocturnal cough.DIAGNOSISEGD to rule out structural disorders beyond achalasia (i.e., mechanical obstruction) that may present similarly to achalasia (pseudoachalasia), especially cancer.Barium swallow (initial test): Esophageal dilation with a "bird's beak" tapering of the distal esophagus (see Fig.).Achalasia; Note the dilated esophagus tapering to a "bird's beak" narrowing (arrows) at the LESManometry (de nitive test): | resting LES pressure, incomplete LES relaxation upon swallowing, and | peristalsis in the body of the esophagus (see Fig. 3).Achalasia; manometry with incomplete LES relaxationTREATMENTShort term: Nitrates, calcium channel blockers, or endoscopic injection of botulinum toxin into the LES.Long term: Pneumatic balloon dilation or surgical (Heller) myotomy.