In this study, doctors want to find out if a shorter cut in the muscle at the bottom of the esophagus (the tube that carries food from your mouth to your stomach) works as well as a longer cut for people with achalasia. Achalasia is when the muscles of the esophagus do not work properly, making it hard to swallow. Participants will have one of two procedures, either a short cut (4 cm) or a long cut (9 cm) in the muscle. The study aims to see if the shorter cut can help relieve symptoms like swallowing difficulties and reduce side effects like acid reflux.

Participants will help by allowing access to their medical records, answering questions up to 6 times over 2 years, and having tests like X-rays. They might also give a small muscle sample for research, but this is optional.

• Study lasts 2 years with follow-up visits.
• Participants can opt out of giving a muscle sample.
• Comparing short and long muscle cuts to see which is better.

To join, you must be 18 or older with specific types of achalasia and have an Eckardt score greater than 3.