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Peroral Endoscopic Myotomy (POEM)

If you have achalasia, a type of esophageal motility disorder, your gastroenterologist may suggest a peroral endoscopic myotomy (POEM). The doctor uses an endoscope with a knife on the end to loosen tight esophagus muscles that cause swallowing disorders.

Achalasia and other types of swallowing disorders occur when the muscle that connects the esophagus to the stomach can’t relax. This makes it hard for the esophagus to move food into the stomach. Common symptoms include heartburn, chest pain, regurgitation of food and coughing due to difficulty swallowing.

Male patient speaking with female physician

After checking into the hospital or surgery center for this minimally invasive procedure, your doctor places you under general anesthesia, so you won’t feel any pain. Once you are unconscious, your gastroenterologist inserts an endoscope—a thin, flexible tube with a light and video camera on the end—down your throat. Miniature surgical-like instruments are inserted through a channel within the endoscope to the area in need of treatment. Through a small incision in your esophageal lining, your gastroenterologist makes tiny cuts in the muscle tissue to relax the stiff esophagus muscles. Your doctor then closes the incision site with small clips.

A peroral endoscopic myotomy takes about two to three hours to complete. People typically stay in the hospital for a couple of days. Talk to your doctor about whether this procedure is right for you.

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