Could adding a throat stretch to botox better ease swallowing trouble?

This study tests whether adding esophageal dilation (stretching the throat) to standard botox injections improves swallowing more than botox alone in adults with achalasia, a rare condition where the esophagus doesn't relax properly. About 50 people who cannot have more invasive treatments will be randomly assigned to one of the two groups. The main goal is to see which approach better reduces swallowing difficulty, measured by a patient-reported symptom score.