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Achalasia Treatment: POEM Best Practices

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1. Peroral‍ Endoscopic Myotomy (POEM) > Fact Sheets – ⁣Yale Medicine

There are several treatments for achalasia, but POEM, a recently developed procedure, is increasingly being ⁣used. POEM relieves symptoms in around 90% of achalasia ⁤cases, and serious complications⁤ are rare. “POEM⁣ is an exciting technique used to perform a ‍myotomy of the LES⁤ for the treatment of achalasia,” says‌ Yale Medicine.

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2. ​per-oral Endoscopic Myotomy (POEM) for Treatment of Achalasia

Per-oral Endoscopic Myotomy (POEM) for Treatment of Achalasia. New approaches to treating achalasia, a neuromuscular condition marked by difficulty swallowing, ‍successfully‍ reduce esophageal ‍sphincter pressure, while avoiding the‌ need for laparoscopic surgery.The standard‍ surgical option for achalasia is⁤ Heller‍ myotomy, a‌ laparoscopic…

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3. POEM⁣ | Achalasia Treatment | What⁢ to Expect | IU Health

patients‍ with achalasia have a tight muscle called the lower esophageal sphincter.The muscle ‍tightness ​makes it hard‌ for liquids,foods and medications ​to pass through normally. … You will discuss options for treatment.POEM is an excellent treatment option for some patients,but not…red on a case-by-case basis after other less invasive approaches have been exhausted, the update states.

For perspective on the POEM clinical practice update, Medscape ⁢Medical News ​spoke with Mouen Khashab, MD, director ⁤of Therapeutic Endoscopy, Johns Hopkins‍ University, Baltimore, and member⁢ of the American Society ⁤for Gastrointestinal ‍Endoscopy.

“The document is very well written and comprehensive, and in ‌terms of the ​best practices, I’m pretty much in agreement with all of them,” Khashab said.

Though, Khashab said he would have liked to see‌ greater emphasis on the value or role of​ a short myotomy⁤ in the esophagus and ⁢cardia.

“There is level I evidence‍ that the ​short ​esophageal myotomy is equivalent to a long esophageal myotomy for type I and II achalasia. When you do a short myotomy, you save procedure time and there is potentially a ‌lower incidence of ⁤blown-out⁣ myotomy or BOM,” Khashab told Medscape medical ‍News.Khashab ​also noted that a long myotomy on the gastric side “likely increases ⁣the risk of reflux disease, and therefore ⁢a limited ⁢myotomy on the gastric side likely also is beneficial.”

This research had‌ no commercial funding. Yang serves as a consultant for Boston Scientific, Olympus, FujiFilm, Microtech, Medtronic, 3D-Matrix, and Neptune Medical; and​ received research ‌support from Microtech and⁣ 3D-Matrix. Khashab had no relevant disclosures.

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Q: What ​is⁣ the significance ‍of ​POEM in the treatment of achalasia?

POEM is a cutting-edge technique that facilitates the myotomy of the​ lower ‍esophageal sphincter‍ (LES) to ameliorate achalasia, a condition characterized by difficulty ⁢swallowing. This minimally invasive approach highlights an essential breakthrough in addressing the disorder as of its ⁣effectiveness ‍in treating the primary cause—the​ hypertonic ‌LES.

Q: ⁤How does‌ POEM compare to customary surgical treatments like Heller myotomy?

⁤ ​ ⁢ POEM offers a less invasive alternative to traditional methods like Heller myotomy, which necessitates ‌laparoscopic surgery. While Heller myotomy has been the standard, POEM stands⁣ out for⁤ its ability to⁣ achieve significant reductions in⁣ LES pressure without the associated risks⁣ and recovery times of laparoscopic surgery.

Q: What are the primary advantages of choosing POEM for treating ⁣achalasia?

⁢ The primary advantages of ​POEM include its minimally invasive nature, which often leads⁤ to quicker recovery times and ⁣reduced postoperative‍ discomfort. Additionally, POEM ​is associated with a potentially lower risk of recurrent Coulston reflux disease‍ compared to traditional surgical methods.

Q: How does the incidence of complications differ between POEM and traditional‌ surgeries ⁤for ​achalasia?

According to⁢ the insights shared by Mouen Khashab, MD, POEM may⁢ potentially reduce the occurrence of blown-out myotomy (BOM). This‍ benefit contributes to the emergence⁣ of POEM as⁣ a more refined and precise treatment modality. However, it is vital to note that the choice between POEM and traditional surgery is often based ‍on the individual patient’s clinical⁢ needs and response to prior treatments.

Q: ‍Can you elaborate on the long-term ⁢effects of POEM in comparison ​to traditional ‌surgical treatments?

Dr. Khashab highlights that a limited myotomy on the gastric side during POEM likely reduces the risk of reflux disease in the long term. This nuanced approach reflects a strategic ⁤advantage,as it preserves the​ functional integrity of the gastric region while effectively treating the​ underlying condition.

Q:​ When would you recommend POEM over‌ traditional surgical interventions for achalasia patients?

POEM is often recommended for patients who have not responded satisfactorily to less invasive treatments or those seeking a minimally invasive option with ​potentially reduced postoperative complications. Given ‌its customized approach and detailed evaluation on a case-by-case basis, POEM presents as ‌a pragmatic⁣ solution within the spectrum of therapeutic choices for achalasia patients.

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Health</strong>\r\npatients‍ with achalasia have a tight muscle called the lower esophageal sphincter.The muscle ‍tightness ​makes it hard‌ for liquids,foods and medications ​to pass through normally. ... You will discuss options for treatment.POEM is an excellent treatment option for some patients,but not...red on a case-by-case basis after other less invasive approaches have been exhausted, the update states.\r\nFor perspective on the POEM clinical practice update, <em>Medscape ⁢Medical News</em> ​spoke with Mouen Khashab, MD, director ⁤of Therapeutic E<em>ndoscopy</em>, Johns Hopkins‍ University, Baltimore, and member⁢ of the American Society ⁤for Gastrointestinal ‍Endoscopy.\r\n“The document is very well written and comprehensive, and in ‌terms of the ​best practices, I’m pretty much in agreement with all of them,” Khashab said.\r\nThough, Khashab said he would have liked to see‌ greater emphasis on the value or role of​ a short myotomy⁤ in the esophagus and ⁢cardia.\r\n“There is level I evidence‍ that the ​short ​esophageal myotomy is equivalent to a long esophageal myotomy for type I and II achalasia. When you do a short myotomy, you save procedure time and there is potentially a ‌lower incidence of ⁤blown-out⁣ myotomy or BOM,” Khashab told <em>Medscape medical ‍News</em>.Khashab ​also noted that a long myotomy on the gastric side “likely increases ⁣the risk of reflux disease, and therefore ⁢a limited ⁢myotomy on the gastric side likely also is beneficial.”\r\n<em>This research had‌ no commercial funding. Yang serves as a consultant for Boston Scientific, Olympus, FujiFilm, Microtech, Medtronic, 3D-Matrix, and Neptune Medical; and​ received research ‌support from Microtech and⁣ 3D-Matrix. Khashab had no relevant disclosures.</em>\r\n<a href="https://iuhealth.org/medical-services/poem-achalasia-treatment">Source</a>\r\n<hr> <br/> <div style="background-color: #f9f9f9; padding: 20px; border-radius: 8px;"><br /><br />\r\n <h2><span id="q-what-is-the-significance-of-poem-in-the-treatment-of-achalasia">Q: What ​is⁣ the significance ‍of ​POEM in the treatment of achalasia?<a href="https://www.yalemedicine.org/conditions/peroral-endoscopic-myotomy-poem"></a></span></h2><div id="aiomatic_toc_container" class=" "><p class="aiomatic_toc_title">Table of Contents</p><ul class="aiomatic_toc_list"><li><a href="#q-what-is-the-significance-of-poem-in-the-treatment-of-achalasia">Q: What ​is⁣ the significance ‍of ​POEM in the treatment of achalasia?</a></li><li><a href="#q-how-does-poem-compare-to-customary-surgical-treatments-like-heller-myotomy">Q: ⁤How does‌ POEM compare to customary surgical treatments like Heller myotomy?</a></li><li><a href="#q-what-are-the-primary-advantages-of-choosing-poem-for-treating-achalasia">Q: What are the primary advantages of choosing POEM for treating ⁣achalasia?</a></li><li><a href="#q-how-does-the-incidence-of-complications-differ-between-poem-and-traditional-surgeries-for-achalasia">Q: How does the incidence of complications differ between POEM and traditional‌ surgeries ⁤for ​achalasia?</a></li><li><a href="#q-can-you-elaborate-on-the-long-term-effects-of-poem-in-comparison-to-traditional-surgical-treatments">Q: ‍Can you elaborate on the long-term ⁢effects of POEM in comparison ​to traditional ‌surgical treatments?</a></li><li><a href="#q-when-would-you-recommend-poem-over-traditional-surgical-interventions-for-achalasia-patients">Q:​ When would you recommend POEM over‌ traditional surgical interventions for achalasia patients?</a></li></ul></div>\r\n<br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n POEM is a cutting-edge technique that facilitates the myotomy of the​ lower ‍esophageal sphincter‍ (LES) to ameliorate achalasia, a condition characterized by difficulty ⁢swallowing. This minimally invasive approach highlights an essential breakthrough in addressing the disorder as of its ⁣effectiveness ‍in treating the primary cause—the​ hypertonic ‌LES.<br /><br />\r\n </p><br /><br />\r\n<br /><br />\r\n <h2><span id="q-how-does-poem-compare-to-customary-surgical-treatments-like-heller-myotomy">Q: ⁤How does‌ POEM compare to customary surgical treatments like Heller myotomy?<a href="https://www.yalemedicine.org/conditions/peroral-endoscopic-myotomy-poem"></a></span></h2><br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n ⁤ ​ ⁢ POEM offers a less invasive alternative to traditional methods like Heller myotomy, which necessitates ‌laparoscopic surgery. While Heller myotomy has been the standard, POEM stands⁣ out for⁤ its ability to⁣ achieve significant reductions in⁣ LES pressure without the associated risks⁣ and recovery times of laparoscopic surgery.<br /><br />\r\n </p><br /><br />\r\n<br /><br />\r\n <h2><span id="q-what-are-the-primary-advantages-of-choosing-poem-for-treating-achalasia">Q: What are the primary advantages of choosing POEM for treating ⁣achalasia?<a href="https://medicalupdate.pennstatehealth.org/gastroenterology-gi-surgery/per-oral-endoscopic-myotomy-poem-for-treatment-of-achalasia/"></a></span></h2><br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n ⁢ The primary advantages of ​POEM include its minimally invasive nature, which often leads⁤ to quicker recovery times and ⁣reduced postoperative‍ discomfort. Additionally, POEM ​is associated with a potentially lower risk of recurrent Coulston reflux disease‍ compared to traditional surgical methods.<br /><br />\r\n </p><br /><br />\r\n<br /><br />\r\n <h2><span id="q-how-does-the-incidence-of-complications-differ-between-poem-and-traditional-surgeries-for-achalasia">Q: How does the incidence of complications differ between POEM and traditional‌ surgeries ⁤for ​achalasia?<a href="https://medicalupdate.pennstatehealth.org/gastroenterology-gi-surgery/per-oral-endoscopic-myotomy-poem-for-treatment-of-achalasia/"></a></span></h2><br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n According to⁢ the insights shared by Mouen Khashab, MD, POEM may⁢ potentially reduce the occurrence of blown-out myotomy (BOM). This‍ benefit contributes to the emergence⁣ of POEM as⁣ a more refined and precise treatment modality. However, it is vital to note that the choice between POEM and traditional surgery is often based ‍on the individual patient’s clinical⁢ needs and response to prior treatments.<br /><br />\r\n </p><br /><br />\r\n<br /><br />\r\n <h2><span id="q-can-you-elaborate-on-the-long-term-effects-of-poem-in-comparison-to-traditional-surgical-treatments">Q: ‍Can you elaborate on the long-term ⁢effects of POEM in comparison ​to traditional ‌surgical treatments?<a href="https://iuhealth.org/medical-services/poem-achalasia-treatment"></a></span></h2><br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n Dr. Khashab highlights that a limited myotomy on the gastric side during POEM likely reduces the risk of reflux disease in the long term. This nuanced approach reflects a strategic ⁤advantage,as it preserves the​ functional integrity of the gastric region while effectively treating the​ underlying condition.<br /><br />\r\n </p><br /><br />\r\n<br /><br />\r\n <h2><span id="q-when-would-you-recommend-poem-over-traditional-surgical-interventions-for-achalasia-patients">Q:​ When would you recommend POEM over‌ traditional surgical interventions for achalasia patients?<a href="https://iuhealth.org/medical-services/poem-achalasia-treatment"></a></span></h2><br /><br />\r\n <p><br /><br />\r\n \r\n \r\n \r\n POEM is often recommended for patients who have not responded satisfactorily to less invasive treatments or those seeking a minimally invasive option with ​potentially reduced postoperative complications. Given ‌its customized approach and detailed evaluation on a case-by-case basis, POEM presents as ‌a pragmatic⁣ solution within the spectrum of therapeutic choices for achalasia patients.<br /><br />\r\n </p><br /><br />\r\n</div> ?">
 

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