Balloon dilation (pneumatic dilatation) — For balloon dilation, the patient swallows a collapsed balloon that is positioned in the LES. An x-ray machine is often used to guide placement of the balloon. When the balloon has been positioned at the LES, it is inflated abruptly to a large size in order to tear the muscle of the LES. This procedure is effective for relieving the swallowing difficulty in patients with achalasia in approximately two-thirds of people, although chest pain persists in some. Patients frequently require more than one balloon dilation treatment for adequate relief.