POEM

Peroral Endoscopic Myotomy

A third-space endoscopy procedure for achalasia cardia and similar motility disorders. Performed entirely through the mouth, no external incision.

What is it?

POEM is an endoscopic technique that treats achalasia by cutting the lower oesophageal sphincter muscle from inside the food pipe, through a tunnel created under the lining.

It produces results comparable to surgical (laparoscopic) myotomy with no external scar.

Who needs it?

Confirmed achalasia cardia, type I, II, or III.
Selected cases of diffuse oesophageal spasm or jackhammer oesophagus.
Patients who have failed pneumatic dilatation.

How it works

Performed under general anaesthesia.

A small entry point is made in the inner lining of the food pipe. The scope tunnels down to the lower sphincter.

The muscle fibres of the sphincter are cut with precise control. The entry point is closed with endoscopic clips.

Typical duration is 60 to 90 minutes.

Preparation

Liquid diet for 2 days before to ensure the food pipe is empty.
Hospital admission the morning of the procedure.

Recovery

1 to 2 nights in hospital. A swallow study may be done the next day before resuming oral fluids.
Soft diet for 7 to 10 days. Most patients return to normal diet within 2 weeks.