There is derangement of the neuromuscular mechanism liable for the usual working of the cardiac sphincter which fails to relax when food reaches it. Dysphagia is the commonest presenting indication in patients with achalasia cardia, and occurs in more than 95% of patients. Some patients especially young and with vigorous achalasia the treatment with pneumatic dilation is usually just successful. Aperiod of pharmacologic treatment before dilation could cause to be esophagus "mature" for dilation.
Identification of this is essential as its presence raise the risk of esophageal perforation during pneumatic dilation to Natural Treatment for Achalasia. We believe that this treatment should be the first option in patients with initial achalasia, in whom an option of regression of alterations exists. The aim of treatment is to reduce the functional obstruction at the cardia.