People who suffer from achalasia have difficulty swallowing that often results in chest pain, vomiting and weight loss. Achalasia is a rare condition that can be misdiagnosed as gastroesophageal reflux disease (GERD), leaving patients with difficult symptoms that cannot be controlled with medications.
The board-certified gastroenterologists affiliated with Memorial Hermann as skilled in the full range of gastrointestinal conditions, including achalasia, and can diagnose the condition and recommend treatment. Peroral endoscopic myotomy (POEM) is a unique minimally invasive treatment that addresses and resolves achalasia.
Conditions that cause chronic reflux and other gastrointestinal symptoms need to be addressed to prevent further damage to the esophagus and other organs. The field of minimally invasive reflux surgery has significantly advanced in recent years and the latest innovations allow patients to live without pain and the need for daily medication.
The nerve and muscle disorder prevents the esophagus from contracting effectively. Without proper muscle contraction, food cannot pass properly through the esophagus and into the stomach. The digestion process takes much longer and leads to chest pain and regurgitation of food. Achalasia tends to develop over time and is sometimes caused by a viral illness or an immune response to a past viral illness. Patients may experience:
Peroral endoscopic myotomy (POEM) is a fairly uncommon procedure used to treat achalasia and other swallowing disorders caused by nerve and muscle abnormalities in the esophagus. The minimally invasive procedure makes small cuts in the muscles of the esophagus so that food can travel from the throat through the esophagus and into the stomach for proper digestion. Surgeons use an endoscope (long, thin tube-like instrument) to reach the esophagus through the mouth; there is no cutting through the skin which allows for fewer side effects and quicker recovery.
If achalasia is diagnosed through an upper endoscopy exam, your physician may recommend the POEM procedure. In addition to treating achalasia, patients who experience other swallowing abnormalities may also be candidates. POEM can also treat esophageal spasms, jackhammer esophagus or nutcracker esophagus.
Using an endoscope and entering the body through the mouth, physicians perform this minimally invasive procedure while the patient is under general anesthesia. Most procedures last about one hour and are performed in an outpatient setting.
Once the patient is asleep, the physician will use the endoscope and create a small cut in the lower portion of the esophagus. The lower esophageal sphincter (LES) connects the rest of the esophagus with the stomach and cutting this area will allow for food for travel easily through the digestive system. The POEM procedure permanently relaxes the restricted esophageal muscles, leaving a wider space for food and liquids to pass.
Minimally invasive procedures have fewer side effects than traditional surgery, but there are still risks involved. Although most people do not experience complications, the following are possible:
Patients usually return home the same day as the POEM procedure and recover within a few days. Some patients experience a sore throat while recovering and need to slowly adjust back to a normal diet.
POEM has a very high success rate, with approximately 90% of patients experiencing significant relief. The esophagus muscles should remain relaxed, and most patients no longer have difficulty swallowing.
Medicare and most commercial insurance plans cover costs for anti-reflux procedures including POEM. Each insurance carrier has different specifications, and most will require a documented diagnoses from your doctor. Speak with both your doctor's office staff and your insurance provider to determine the specifics of your plan's coverage.
Achalasia is being successfully treated with the POEM procedure, allowing patients to experience normal food digestion without painful symptoms. If difficulty swallowing is affecting your quality of life, it's time to speak with your doctor about this minimally invasive solution.
The physicians affiliated with Memorial Hermann are leaders in reflux procedures and help patients identify the best treatment option to meet their specific and individual health needs.
For a referral to a reflux surgeon, please complete the form below. You may then proceed to enter your insurance information. If you don't have your insurance information ready, you will receive an email with a link to the referral request form that you can submit later at your convenience.