A benefit of having an endoscopic procedure, especially for swallowing disorders, is that there are no incisions in the chest or abdomen and includes a minimal or sometimes no hospital stay post-procedure. Watch this video by Dr Mahadevan, HOD & Senior Consultant, Gastroenterology, Gleneagles Global Health City, Chennai to know how POEM procedure is done.

POEM procedure is mainly used to treat patients with achalasia cardia. It basically means that an endoscope is passed through the mouth and through that, an incision is made in the lower part of the esophagus so that those patients who have difficulty in swallowing due to achalasia cardia can be relieved. Achalasia is a motility disorder that involves the esophagus from which the food is swallowed; the lower esophageal sphincter fails to relax and the esophagus also fails to contract and pass the food into the stomach. Achalasia cardia is quite a rare condition.

Symptoms of achalasia cardia are that the patients will present with difficulty in the intake of both, solids & liquids for quite a couple of months or even years. They may have regurgitation or chest pain or sometimes they experience aspiration that leads to chronic complications.

POEM is performed with an endoscopic procedure under IV anaesthesia and the patients will be fully sedated when the endoscope is passed and the incision is made a couple of centimeters above the gastroesophageal junction. Here, a special technique called submucosal tunneling is used where space is created between the mucosa, underneath the muscle layer and a tunnel is completed across the junction and into the stomach. Then the muscle fibers in the tunnel are cut which are very similar to the surgical technique known as Heller Myotomy that has been performed classically for decades for achalasia cardia. Once the procedure is complete, the tunnel is closed with hemoclips so that food or water enters into the tunnel and the patient recovers fast and performs well as compared to a surgical procedure.