Today we will discuss the new treatment of achalasia cardia, POEM (Peroral Endoscopic Myotomy). We know that achalasia cardia is a disease of the food pipe.
There is a sphincter between our food pipe and stomach, which we refer to as LES (Lower Esophageal Sphincter)
Some people find it hard to swallow food or water because their food pipe becomes tight at the lower end.
This condition is called Achalasia, and one of the most effective treatments for it is a modern procedure known as POEM (Peroral Endoscopic Myotomy).
In this video, I shall explain what POEM is and how it helps in easy and safe treatment of Achalasia.
Understanding the Problem
Normally, when we eat food, it travels through the esophagus (food pipe) and enters the stomach.
At the junction of these two, there is a ring of muscle called the lower esophageal sphincter (LES).
In Achalasia, this sphincter becomes stiff and does not open properly, making it difficult for food and water to pass.
This causes problems like difficulty in swallowing and chest discomfort.
How is POEM Done?
Before the POEM procedure, doctors usually recommend a few tests such as:
- Blood tests
- Barium swallow
- Esophageal manometry
These tests help confirm the diagnosis and decide the treatment plan.
What is POEM?
POEM (Peroral Endoscopic Myotomy) is an advanced, scar-free, and minimally invasive treatment for Achalasia. It is performed using an endoscope, a thin, flexible tube with a camera that is passed through the mouth – so no cuts are made on the outside of the body.
Let’s understand the steps in detail:
Step-by-Step POEM Procedure
1. Hospital Admission
The patient is admitted for around 2 days. The procedure is done under general anaesthesia, so the patient remains fully unconscious and feels no pain.
2. Creating Entry Point
A small cut is made inside the esophagus lining using the endoscope.
3. Making the Tunnel
A tunnel is created inside the esophagus wall to reach the lower esophageal sphincter muscle.
4. Cutting the Muscle
The tight muscle is carefully cut to release the pressure. This allows food to move easily into the stomach. Imagine it like cutting a tight rubber band to loosen it.
5. Closing the Entry
After cutting the muscle, the entry point is sealed with special clips. These clips fall off on their own in a few weeks.
Recovery After POEM
- Next Day: Patients can start drinking liquids.
- Within 48 Hours: Most patients are ready to be discharged from the hospital.
Why Choose POEM?
- No external cuts or stitches
- Painless and scar-free procedure
- Short hospital stays (usually 2 days)
- Quick recovery
- Highly effective for treating Achalasia
