Per-oral Endoscopic Myotomy (POEM) for Achalasia

POEM is an endoscopic procedure that is performed for the treatment of certain disorders of swallowing including Achalasia. The following blog explains, more about the procedure and its advantages.

Per-Oral Endoscopic Myotamy (POEM) is a novel procedure used to treat Achalasia, an unusual condition that affects the esophagus- the swallowing tube that connects mouth and stomach. It is a painful condition that makes it difficult for food and liquid to pass from the oesophagus to the stomach.

     Achalasia occurs when nerves in the oesophagus become damaged. Consequently, the oesophageal muscles become paralyzed and loses its capability to push food down into the stomach.Thus the food gets settled in the oesophagus and sometimes gets regurgitated. Inability to swallow, heartburn, belching, frequent chest pains, and coughing at night are the common symptoms.

     Achalasia, the condition as such, has no cure. Once the muscles are paralyzed, they cannot be reversed. However, the symptoms are manageable through many surgical and non-surgical procedures.

     One of the specialized and predominant procedures used to treat this condition is Per-Oral Endoscopic Myotomy (POEM). Dr. Roy J Mukkada, the Director of GI Endoscopy & Senior Consultant and Head of Gastroenterology at VPS Lakeshore is a pioneer of this procedure in Kerala. He is one of the few doctors in the country who performs this procedure regularly. The team led by Dr. Roy J Mukkada has been performing this procedure regularly for the last 8 years.

What is POEM?

POEM is a minimally invasive scarless endoscopic surgery where an endoscope; a flexible tube with camera attached to it, is passed through the mouth to the throat and into the oesophagus. In order to let solids and liquids pass through the food pipe without pain, an incision is made inside the oesophagus lining, and the muscle is cut without injring the lining of the oesophagus. This procedure is an inpatient one done under general anaesthesia and can take one to two hours to finish. The recovery is quick compared to conventional surgery. Usually patient is discharged within 4th or 5th day. The patient can eat food from the 3rd day.

Advantages of POEM

No incisions in the chest or abdomen.

No visible scars.

Minimal post-operative pain.

Can avoid a prolonged hospital stay.

This procedure also helps to treat Distal Oesophageal Spasm, which is another rare ailment of the oesophagus where the patient's food pipe narrows due to frequent spasms and makes it difficult to swallow food or water easily.

     Swallowing disorders are agonizing and make eating food a distressing and unpleasant experience. POEM aids the patient to find liberation from this situation. A 87 year old patient is the oldest patient we have done POEM at VPS Lakeshore for Distal Oesophageal.