Assessing the Efficacy of Steroid Treatment of Achalasia

Inclusion criteria:

- Adults ages 18-90 with a diagnosis of achalasia confirmed by findings on esophageal
manometry and barium esophagogram will be eligible for the study.

- Eckardt score6 greater or equal to 6 or 2 or greater for dysphagia and/or
regurgitation

- Symptoms less than 2 years

Exclusion criteria:

- Medical conditions such as severe heart or lung disease that preclude safe performance
of endoscopy and injection;

- Greater than mild esophageal dilation

- Type 1 achalasia as defined by the Chicago classification scheme7 and/or esophageal
diameter > 3cm;

- Prior treatment for achalasia

- Use of medications that might affect LES pressure such as anticholinergics or calcium
channel antagonists

- Symptom duration greater than 2 years

- Inability to read due to: Blindness, cognitive dysfunction, or English language
illiteracy

- Disorders which predispose to unreliable responses such as Schizophrenia, Alzheimer's
disease or significant memory loss

- Pregnant and lactating females will be excluded as steroids are not thought safe for
the fetus.