Achalasia: Botulinum injections are most effective of all the options for relieving a lower oesophageal sphincter restriction which leads to achalasia. Nifedipine, nitrates or sildenafil can also be used, but are less effective. Surgically, Heller’s oesophageal myotomy is the best treatment option, it can be done via an abdominal incision or laparascopically.