Brief Summary: OBJECTIVES I Compare the efficacy of two doses of botulinum toxin in the treatment of achalasia
II Compare the safety of these two doses in these patients
Detailed Description: PROTOCOL OUTLINE This is a randomized double blind dose response study Patients are randomized to one of two treatment arms each arm receives a different dose of botulinum toxin type A
All patients undergo a flexible upper gastrointestinal endoscopy Botulinum toxin is injected into the lower esophageal sphincter into each of 4 quadrants Some patients may receive a second treatment depending on response andor time of relapse
Patients are followed daily for 7 days then every 1-6 months for 1-2 years after treatment
Completion date provided represents the completion date of the grant per OOPD records