Assessing the Efficacy of Steroid Treatment of Achalasia

Inclusion criteria: * Adults ages 18-90 with a diagnosis of achalasia confirmed by findings on esophageal manometry and barium esophagogram will be eligible for the study. * Eckardt score6 greater or equal to 6 or 2 or greater for dysphagia and/or regurgitation * Symptoms less than 2 years Exclusion criteria: * Medical conditions such as severe heart or lung disease that preclude safe performance of endoscopy and injection; * Greater than mild esophageal dilation * Type 1 achalasia as defined by the Chicago classification scheme7 and/or esophageal diameter \> 3cm; * Prior treatment for achalasia * Use of medications that might affect LES pressure such as anticholinergics or calcium channel antagonists * Symptom duration greater than 2 years * Inability to read due to: Blindness, cognitive dysfunction, or English language illiteracy * Disorders which predispose to unreliable responses such as Schizophrenia, Alzheimer's disease or significant memory loss * Pregnant and lactating females will be excluded as steroids are not thought safe for the fetus.