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Peroral Endoscopic Myotomy (POEM) is an endoscopic procedure used to treat achalasia and other esophageal disorders. Achalasia, a rare disorder, affects swallowing by limiting the movement (motility) of the esophagus and the ability of the sphincter valve (bundle of muscles) between the esophagus and stomach to relax. This makes it very difficult to swallow.
One of the most effective therapies for achalasia is to relax the lower esophageal sphincter (LES), by doing a POEM procedure where a small cut is made in the sphincter muscle so that food can pass from the esophagus to the stomach. POEM offers similar outcomes as surgery, but with the added benefit of not having to make a cut on the outside of the body. The advanced endoscopists who perform the POEM procedure, collaborate with specialists in our Gastrointestinal Motility Program to ensure accurate diagnosis and explore all treatment options to provide the best care to patients.
Before your procedure, you will need to follow specific preparation instructions. Your doctor will discuss them with you in detail. Preparation instructions are as follows:
On the day of the procedure, arrive two hours before your POEM procedure start time. When you arrive, you will register and give your medical history.
During a POEM procedure, a highly trained endoscopist inserts a flexible tube, or endoscope, through the mouth into the esophagus. Using special techniques, the scope can move through of the esophagus through a tunnel which the endoscopist creates in the wall of the esophagus to reach the lower esophageal sphincter. A cut, is then performed of the sphincter muscle and the tunnel is then closed with clips or sutures placed through the scope before the scope is gently removed through the mouth. After the procedure, patients may have to drink a barium solution and have X-rays taken of their esophagus to ensure they can swallow normally. Patients typically can go home the day after the procedure.
After you recover from the effects of the anesthesia, your doctor will discuss with you the results of the procedure and the next steps. Patients stay overnight at the hospital after POEM for further monitoring.
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