<prompt> Which of the following mode of treatment for achalasia is associated with high rate of recurrence?Pneumatic dilatationLaproscopic myotomyOpen surgical myotomyBotullin toxin  <response>: Botulinum toxin, injected into the lower esophageal sphincter under endoscopic guidance, inhibits acetylcholine release from nerve endings and improves dysphagia in about 66 of cases of achalasia for at least 6 months. This technique is useful only for temporary relief of symptoms, thus associated with high rate of recurrence. Ref: Harrisons Internal Medicine, 18th Edition, Chapter 292 