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POEM for achalasia cardia

POEM (Peroral Endoscopic Myotomy) is an endoscopic procedure used to treat swallowing disorders, most commonly for achalasia. Achalasia and other swallowing disorders are usually caused by the esophagus muscles and the lower esophagus sphincter muscles not relaxing, making it hard to swallow and hard for the food to pass into the stomach

Why and when is it done

POEM has been shown to be highly effective in relieving symptoms of achalasia, such as difficulty swallowing, regurgitation, and chest pain. It has a lower risk of complications compared to traditional surgical treatments for achalasia

Benefits of POEM

A benefit of having an endoscopic procedure, especially for swallowing disorders, is that there are no incisions in the chest or abdomen and includes a minimal or sometimes no hospital stay post-procedure.

Risks associated with POEM

While POEM is a very safe procedure, it does carry certain risks which come with every procedure:

  • Bleeding while cutting the muscle fibres
  • infections as is the case with any surgical procedure
  • A tear of the esophageal wall
  • Increase in acid reflux - GERD
  • Reactions and allergies due to anesthesia
  • Reactions to medications and damage to nearby structures

How is the procedure performed

Using the endoscope, the surgeon creates a tunnel within the layers of the esophageal wall, starting from the inside of the esophagus and extending into the muscular layer. This tunnel is then widened to allow easier passage of food through the esophagus. The procedure involves cutting the muscle fibers of the lower esophageal sphincter, which is the muscular valve that controls the flow of food into the stomach. By cutting the muscle fibers, POEM helps to relax the sphincter and improve the passage of food into the stomach.