POEM Procedure

Achalasia is a very rare swallowing disorder involving disordered contraction of the muscles of the oesophagus and the sphincter between the oesophagus and stomach. In patients with achalasia, the sphincter remains very tight, not allowing food to pass into the stomach. Common symptoms include difficulty swallowing or regurgitation of food, as well as weight loss.

Initial investigation may involve a routine upper endoscopy or barium (xray contrast) swallow test to assess for other disorders that may be more common. The diagnosis of achalasia requires a specialised test called high resolution oesophageal manometry.

POEM 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. This ensures faster recovery time and return to normal activities.

POEM procedure is performed in the endoscopy unit under a general anaesthesic. 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. Please refer to the video below.

Overnight admission is recommended for observation and 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.

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