POEM Procedure and Achalasia

What is Achalasia?

Achalasia is a very rare swallowing disorder involving the sphincter (valve) muscles between the oesophagus (food pipe) and the stomach.  Normally these muscles relax to allow swallowed food to enter the stomach.  In patients with achalasia, the sphincter does not relax properly and as a result, patients cannot eat normally.

How is achalasia diagnosed?

If you have difficulty swallowing, our doctors will assess and perform a routine endoscopy to assess for more common disorders.  The diagnosis of achalasia requires a special test called high resolution oesophageal manometry.  If achalasia is diagnosed, our doctors will discuss the various options for treatment as these vary depending on many factors.

How is Achalasia treated?

Traditionally, the treatment of achalasia involved a surgical operation called Heller myotomy.  Myotomy involves cutting the sphincter muscle to allow food to pass more easily.  Over the last few years an endoscopic treatment called POEM (Per Oral Endoscopic Myotomy) has been used very successfully to treat achalasia.

The benefit of POEM is that it is an endoscopic (non-surgical) procedure which takes between 1-2 hours to perform and does not involve any incisions on your abdomen or chest.   Therefore, recovery time and return to normal activities may be much quicker than a surgical operation.

What does POEM involve?

POEM procedure is performed in the endoscopy unit under general anaesthesia.  The flexible scope is inserted and used to create a “tunnel” or new pathway in the oesophagus between the normal lining of the oesophagus.  A special knife is then used to divide the tight muscles that are causing the swallowing problems.  Once this is done, the opening of the tunnel is closed with endoscopic clips.

You will be admitted overnight for observation and will have a special barium x-ray test the following day prior to starting back on fluids.  Your doctor will then advise on resumption of your diet.

Are there risks with POEM?

As with any interventional endoscopic procedure, there are small risks of complications.  These will be discussed at length during your consultation.

Further Information

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