What is the primary surgical intervention for achalasia that offers the longest symptom relief?

Surgical myotomy is recognized as the primary surgical intervention for achalasia that provides the longest symptom relief. In achalasia, the esophagus becomes unable to effectively transport food to the stomach due to the failure of the lower esophageal sphincter to relax properly. Surgical myotomy involves cutting the muscles of the lower esophageal sphincter, which allows for easier passage of food into the stomach and alleviates the symptoms of this condition.

This intervention is typically more effective than other treatment options because it addresses the root cause of the condition, leading to a significant reduction in symptoms such as dysphagia (difficulty swallowing) and chest pain. Patients who undergo surgical myotomy often experience a substantial improvement in their quality of life and symptom relief that can last for many years.

While balloon dilation can relieve symptoms temporarily by dilating the lower esophageal sphincter, its effects are generally less durable compared to surgical myotomy. Botulinum toxin injection may offer short-term relief but is more commonly used in patients who are not surgical candidates, and its efficacy diminishes over time. Medications with nitrates may provide symptomatic relief by relaxing smooth muscles but do not address the structural problem and are not a long-term solution. Thus, surgical my