Worried

I am not medically qualified, but  the myotomy means cutting the muscles that are clamping your lower oesophageal sphincter tight shut.   This should allow food to pass through, probably because of gravity, more easily, and means you can then take in relatively normal food, soft at first and regain nutritional feeding.   The chances are that the extreme pressure that causes much of the pain of spasms will be relieved, but this is not necessarily guaranteed.

The lower oesophageal sphincter is a valve by your diaphragm that is there to stop stomach acid rising into your oesophagus, not least because the lining of your oesophagus is different, and cannot cope with the strong acid, leading to heartburn.   So what would also be considered is a 'wrap' of the top part of your stomach (the fundus) around the base of your oesophagus to recreate a valve-like effect.   This is a procedure to prevent acid reflux occurring that would be a side efefct of the surgery.

I am not sure precisely what would be meant by longitudinal myotomy, other than the obvious implication that the myotomy would be along the length of the oesophagus rather than across its width.   The details of this are for the surgeon to explain, and it could conceivably be an alternative to a 'wrap'.   I do not know.

The majority of people who have these surgical procedures do find that they benefit from it, and have a great improvement in their quality of life.   You need to be treated by an experienced specialist, which appears to be what is happening.   The underlying causes of what creates the condition will not have disappeared, however, and you will always have to be careful about eating, and avoiding stress that might exacerbate the nerve system around the oesophagus that creates the problem in the first place.   The longer you leave it untreated, the worse it will be to try and rectify, and your oesophagus can become big and baggy from the weight of undigested food left in it, and this make the muscle tone deteriorate.

William,

I too have Achalasia and it sounds like your Doc is wanting to do a Heller Myotomy that is the standard procedure for Achalasia. The other is called POEM and depending on your situation and the doctors experience will determine which one. I have lived with Achalasia now and I have spasms too but I have managed to stay away from surgery. It's important to change your diet and don't force food down. Also you need support and in the states there are good groups available. Go to Achalasia.us and get on the world map for Achalasia. Also you can get ahold of me and I can get you names of other good groups to be involved with. 

I would recommend a second option if your not sure. This disease is too rare to be unsure of your self and the doctors. I spent over a year looking for a good doctor to support me. The main thing is to know that there is information available. Good luck Williiam 

Oh my WILLIAM are you able to keep anything down or swallow at all? Here is what I know about rehydration get some good coconut water and sip on it throughout the day. It will give you more nutrients than just water. I have been in your shoes where I couldn't get anything to go down. That is when I put myself on liquids and fortunately for me it helped to eliminate the pressure on my E. It sounds like you are having big difficulties! Please keep me posted. J

Also William the nerve that is effected is called the vagus nerve and it starts in the brain. That nerve also regulates heart, lungs and swallowing too. Relaxation does help but it is hard to relax when you feel like you are choking.