Achalasia or Something Else??

I have been suffering with GERD for about the past 8 years or so.  Lately the chest pain and heartburn have become almost unbearable.  Based on the results of a recent esophageal manometry and Ph impedence study my gastroenterologist advised me that I was refluxing material other than acid and ordered an uppper endoscopy with biopsy of the small intestine.  Curiously enough, he also presribed 600 mg of Actigall daily and told me that he during the upper endoscopy he was also going to inject botox into my esophageal sphincter.  The doctor won't tell me what the problem is other than to say it's "very complicated".  Much of the literature I've read on botox therapy for esophageal sphincter issues suggests it's used when the patient suffers from achalasia.  My gastroenterologist has stopped short of calling it that, but what else could it be if this is the treatment course he intends to follow?  Is there something he's worried about but isn't telling me just yet?  

[Ratnakar Kini, MD]

Hi,
Botox is usually used to treat achalasia cardia and not GERD.
Esophageal manometry would have helped in the diagnosis.
Achalasia also can cause heartburn.