<prompt> Diffuse oesophageal spasm treatment is?Pneumatic dilatationOxybutyninNitratesBotulinum toxin and pneumatic dilation  <response>: Choice D is closely worded and is used primarily in the treatment of achalasia. Diffuse oesophageal spasm is managed by the following interventions: Nitrates and CCB Hydralazine Botulinum toxin Anxiolytics Long myotomy or esophagectomy for severe weight loss or unbearable in Diffuse oesophageal spasm Nutracker oesophagus Hypeensive LES Simultaneous non peristaltic contractions 20 of wet swallows Mean peristaltic amplitude of 180 mm Hg for increased duration of contraction 7 seconds normal peristaltic sequence Elevated LES pressure 26 mmHg normal LES relaxation Normal oesophageal peristalsis 