PROVIDENCE, R.I. — As Achalasia Awareness Month came to a close, Brown Surgical Associates surgeon Marcoandrea Giorgi, MD explained the condition, who’s most affected, and the different treatments – including POEM – an incision-free procedure offered in Rhode Island exclusively by Brown Surgical Associates.
POEM, or per-oral endoscopic myotomy, treats achalasia – a rare disorder that makes it difficult for food and liquid to pass into the stomach.
“Now more than ever, people want to avoid a long hospital stay if at all possible. Both of these cutting-edge procedures not only provide relief for people suffering from these two conditions but also drastically reduce the amount of time those patients will need to stay in the hospital following the procedure,” said Dr. Luhrs.
POEM is similar to a heller myotomy for the esophagus but is performed endoscopically, eliminating the need for incisions.
Achalasia occurs when nerves in the esophagus become damaged and, over time, leave the esophagus paralyzed and unable to squeeze food into the stomach. As a result, food can build up and wash back up into the mouth. This can cause reflux, heartburn, chest pain, trouble swallowing, nausea, vomiting, and regurgitation of food.
While there have been historically numerous endoscopic treatments available, like dilations or injections, surgical myotomy remains the best therapy to guarantee long-term results. Myotomy has historically been performed in laparoscopic or robotic surgery with incisions over the patient’s abdomen. “With POEM we are now able to perform the same effective myotomy using cameras through the mouth like a routine endoscopic procedure without the need for incisions in the abdomen,” explained Dr. Giorgi.
The surgeon cuts the inner layer of the patient’s feeding pipe or the esophagus’ mucosa and creates a tunnel within the wall of it all the way to the stomach. Then the muscular layer of the esophagus is cut from within the tunnel itself with an energy device, relieving the pressure in the system and allowing easier passage of food. The mucosa is then clipped closed.
There is no cure for achalasia and patients who undergo the POEM procedure will still need to manage their condition with treatment from a gastrointestinal doctor. However, this procedure can greatly alleviate the uncomfortable and sometimes painful symptoms, thus improving quality-of-life for patients.