Peroral Endoscopic Myotomy (POEM) is an advanced, minimally invasive procedure used to treat swallowing disorders, particularly achalasia. In this condition, the lower esophageal sphincter (LES) fails to relax properly, making it difficult for food and liquids to pass into the stomach. POEM is also used in the treatment of other motility disorders such as Distal Oesophageal Spasm and Nutcracker Oesophagus.

Patients with achalasia commonly experience symptoms such as difficulty swallowing (dysphagia), where food feels stuck in the chest while eating. Some patients may also experience chest pain or discomfort, which can sometimes mimic heart-related conditions. Regurgitation of undigested food, especially while lying down, is another common symptom. Over time, difficulty in swallowing may reduce food intake and result in unintended weight loss.

The POEM procedure is performed using an endoscope, which is passed through the mouth, eliminating the need for external cuts or scars. During the procedure, a flexible tube equipped with a camera is guided into the esophagus to clearly visualize the affected area. A small incision is then made in the inner lining of the esophagus to safely access the muscle layer. A tunnel is carefully created within the esophageal wall to reach the tight muscle without disturbing surrounding tissues. The problematic muscle fibers are then divided to relieve the obstruction and improve swallowing. Finally, the entry point is closed using clips to promote proper healing and reduce the risk of complications.

POEM offers several advantages over traditional surgical procedures. Since the procedure is performed internally, there are no visible external scars. Most patients recover quickly and are able to return to normal activities sooner. The hospital stay is usually short, with many patients discharged within one to two days. The procedure also provides long-term relief from swallowing difficulties and significantly improves the patient’s quality of life.

Although POEM is generally considered safe, certain risks and complications may occur. These include bleeding or infection, which are uncommon and usually manageable with appropriate medical care. In rare cases, air leakage into surrounding tissues may occur, but this can typically be monitored and treated effectively. Some patients may also develop acid reflux symptoms after the procedure and may require medication for management.

Dr. Lorance Peter has been a pioneer in performing the POEM procedure in Karnataka and has played a significant role in advancing minimally invasive treatment options for patients with esophageal motility disorders in the state.

In conclusion, POEM is a safe and effective treatment option for achalasia and other esophageal motility disorders. With early diagnosis, timely treatment, and regular follow-up care, patients can achieve significant symptom relief and improved quality of life.