Peroral Endoscopic Myotomy (POEM) is a minimally invasive endoscopic procedure used to treat achalasia and other esophageal motility disorders. Achalasia is a condition where the lower esophageal sphincter (LES) fails to relax properly, making it difficult for food and liquids to pass into the stomach. This leads to symptoms like difficulty swallowing, chest pain, and regurgitation.
POEM is performed using an endoscope (a flexible tube with a camera and instruments) that is passed through the mouth, eliminating the need for external incisions. Since its introduction in 2008, POEM has become a revolutionary alternative to traditional surgical treatments such as Heller myotomy.
1. The endoscope is inserted through the mouth into the esophagus.
2. A small incision is made in the inner lining of the esophagus.
3. A tunnel is created within the esophageal wall.
4. The surgeon cuts (myotomy) the abnormal muscle fibers of the lower esophageal sphincter.
5. The entry site is closed with endoscopic clips.
POEM is usually recommended for patients with:
Although POEM is generally safe, some possible risks include:
Peroral Endoscopic Myotomy (POEM) has emerged as a safe, effective, and minimally invasive treatment for achalasia and other esophageal motility disorders. It avoids external incisions, provides rapid recovery, and offers long-term relief from swallowing difficulties. With high success rates and fewer complications, POEM is considered a breakthrough in the management of complex esophageal disorders.
POEM is a minimally invasive endoscopic procedure used to treat achalasia and other esophageal motility disorders. During this procedure, the inner muscles of the esophagus are cut through an endoscope to relieve swallowing difficulties.
POEM is suitable for patients who suffer from difficulty swallowing (dysphagia), food sticking in the esophagus, chest pain, or frequent regurgitation, especially when medications or balloon dilation have not been effective.
The procedure usually takes between 45 minutes to 2 hours. Most patients stay in the hospital for 1–2 days and can return to normal activities within a few days.
After POEM, patients are usually advised to start with a liquid diet, then gradually move to soft foods, and finally resume a normal diet within a few weeks, under the doctor’s guidance.
POEM is considered a safe procedure with a success rate of over 90%. However, potential risks may include gastroesophageal reflux disease (GERD), infection, bleeding, or, in rare cases, other complications.