Peroral Endoscopic Myotomy (POEM)

Providers within Virginia Mason’s Digestive Disease Institute now offer the less-invasive option of Peroral Endoscopic Myotomy (POEM) for the treatment of achalasia. Achalasia is an esophageal motility disorder in which a muscle at the lower end of the esophagus does not function properly, which obstructs the passage of food, causing swallowing difficulties, and sometimes chest pain, regurgitation, coughing and breathing problems.

Specially trained therapeutic endoscopists and surgeons use high-definition upper endoscopes to perform the procedure, which typically takes approximately two to three hours. Here's what you could expect during the procedure:

1. A camera (the endoscope) is inserted into your mouth and down your esophagus.
2. The camera tunnels into the lining of the esophagus and makes a pathway.
3. A special knife is then attached to the end of the camera which cuts the obstructing muscle, the lower esophagus sphincter.
4. After this is completed, clips are placed on the lining of the esophagus to close the tunnel. The camera is then removed.  The procedure typically relieves the tightness and allows the esophagus to empty more easily and the patient to resume a more normal diet.

What are the benefits of POEM?

Achalasia can be treated with endoscopic balloon dilation, injections of botox, or surgery, which all can be done at Virginia Mason.

Patients undergoing POEM may have comparable outcomes and quicker recovery when compared to traditional treatments for achalasia, although there is not enough data yet to ensure that. 

What is the recovery process for POEM?

Following POEM, patients are normally hospitalized for an average of one to two days for monitoring. Patients are asked to follow a special diet during the recovery period.

What if I have other questions or concerns about POEM?

The nurses and care team in Virginia Mason's Digestive Disease Institute are available Monday through Friday from 8:30 a.m. to 4:30 p.m. They can be reached at (206) 223-2319.