Peroral Endoscopic Myotomy (POEM)

Before POEM, you’ll need several diagnostic tests to make sure you are a candidate. These may include an upper endoscopy to rule out stomach or esophageal cancer and an esophageal manometry study to measure muscle contractions and confirm that you have achalasia. You will also have an esophagram, which will help your doctor understand how your esophagus moves.

Two days before POEM, you’ll need to follow a clear liquid diet.

During the procedure, your doctor will insert an endoscope into your mouth and down your throat to your esophagus. When the endoscope reaches the lower esophageal sphincter, your gastroenterologist will cut the muscle to relax the esophagus so food can pass more easily into your stomach.

Peroral endoscopic myotomy is performed under general anesthesia, so you are not awake during the procedure. After the procedure, you may have some temporary pain in your chest or throat that can be controlled with pain medications.

For many people, POEM offers a quick recovery, no scar and a short hospital stay. What’s more, it can help them eat normally again and significantly improve their quality of life.

But like any procedure, there are risks associated with POEM. Although these are rare, risks include leaks, tears or bleeding in the esophagus.

POEM is not recommended for all patients based on their overall health and medical conditions. For patients who are not candidates for POEM, our specialists may recommend other treatments, such as botulinum toxin injections or a Heller myotomy.

The most common long-term side effect of POEM is heartburn, which can be treated with medication.

Yes, it is possible that symptoms can return after the POEM procedure. If this is the case, another peroral endoscopic myotomy may be recommended.

Recovery from a peroral endoscopic myotomy is typically faster than recovery from a Heller myotomy. If you are like most patients, you will be able to return home the day after your procedure. In general, you can return to normal activities in a few days.

After a peroral endoscopic myotomy, you’ll need to follow a soft diet for about a week. You’ll also need to take medication to reduce your stomach acid. Eventually, you will be able to return to your normal diet.

After you have POEM, you’ll have a checkup with your doctor in one month so we can follow your progress.