Third-Space Endoscopy- POEM

Peroral Endoscopic Myotomy (POEM) Advanced Treatment for Esophageal Motility Disorders

What is the POEM Procedure?

Peroral Endoscopic Myotomy (POEM) is a revolutionary, minimally invasive procedure used to treat esophageal motility disorders, such as achalasia and diffuse esophageal spasm. The procedure involves using an endoscope to access and cut abnormal muscles in the esophagus, improving the ability to swallow and relieving symptoms.

At Central Gastro, we offer POEM as a state-of-the-art solution for patients seeking effective, long-term relief from esophageal motility disorders without the need for traditional surgery.

Why is POEM Performed?

POEM is performed to address the underlying cause of esophageal motility disorders, which is often related to dysfunction of the esophageal muscles or the lower esophageal sphincter (LES). Common conditions treated with POEM include:

• Achalasia: A condition where the LES fails to relax, causing difficulty swallowing.
• Diffuse Esophageal Spasm: Irregular muscle contractions in the esophagus that cause chest pain and swallowing problems.
• Esophagogastric Junction Outflow Obstruction (EGJOO): Impaired relaxation of the LES with partial obstruction.
• Jackhammer Esophagus: A condition characterized by excessively strong esophageal contractions.

Symptoms Treated by POEM

Patients suffering from esophageal motility disorders often experience symptoms such as:

• Difficulty swallowing (dysphagia)
• Regurgitation of undigested food
• Chest pain or discomfort
• Persistent heartburn or acid reflux
• Unexplained weight loss due to eating difficulties

POEM provides long-lasting relief from these symptoms, restoring quality of life.

How is the POEM Procedure Performed?

POEM is a minimally invasive endoscopic procedure performed under general anesthesia.

Steps of the Procedure:

1. Preparation:
   • You will need to fast for 6–8 hours before the procedure.
   • General anesthesia is administered to ensure comfort and safety.
2. Procedure:
   • A flexible tube with a camera (endoscope) is inserted through the mouth into the esophagus.
   • A small incision is made in the esophageal lining to create a submucosal tunnel.
   • The abnormal muscles in the esophagus or LES are cut to improve swallowing function.
   • The mucosal incision is then closed using specialized clips or sutures.
   • The procedure typically takes 1–2 hours.
3. Recovery:
   • After the procedure, you will be monitored in recovery and may need to stay overnight for observation.

Benefits of POEM

• Minimally Invasive: No external incisions, reducing recovery time and discomfort.
• Effective Relief: Significant improvement in swallowing and reduction of symptoms.
• Long-Term Results: Durable outcomes for esophageal motility disorders.
• Shorter Recovery Time: Faster return to normal activities compared to traditional surgery.
• Preserves Function: Avoids the need for open or laparoscopic surgery.

What to Expect After the Procedure

• Dietary Guidelines: You will start with a liquid diet and gradually transition to soft and regular foods over a few weeks.
• Temporary Symptoms: Mild chest discomfort, sore throat, or bloating may occur but typically resolves within a few days.
• Follow-Up Care: Regular follow-ups include imaging and endoscopic evaluations to ensure successful healing and symptom relief.

Who is a Candidate for POEM?

POEM may be the right solution for patients with:

• Diagnosed achalasia or other esophageal motility disorders.
• Persistent swallowing difficulties not responding to medication or dilation.
• Symptoms interfering with daily life, such as regurgitation or significant weight loss.

Our specialists at Central Gastro will conduct a thorough evaluation, including diagnostic tests such as manometry, endoscopy, or barium swallow studies, to determine if POEM is the most appropriate treatment option.