Peroral Endoscopic Myotomy (POEM) Surgery – Procedure & Recovery

Peroral Endoscopic Myotomy (POEM) is an advanced, minimally invasive endoscopic surgical technique used to treat esophageal motility disorders, most commonly Achalasia Cardia.

Understanding Achalasia Cardia

Achalasia Cardia is a rare disorder in which the lower esophageal sphincter (LES) fails to relax properly, resulting in difficulty moving food from the esophagus into the stomach.

The following are the common symptoms of achalasia:

• Difficulty in swallowing (>90%)
• Nasal regurgitation of undigested food (76 – 91%)
• Nocturnal cough (30%)
• Chest pain (25 – 64%)
• Heartburn (18 – 52%)
• Weight loss (35%)

Achalasia is diagnosed through endoscopy and esophageal manometry.

Traditional vs Modern Treatment Approaches

Traditionally, Heller’s Myotomy was the standard surgical treatment for achalasia. However, POEM has now emerged as a highly effective and less invasive alternative.

POEM is performed entirely through an endoscope, meaning no external incisions or scars, making recovery quicker and more comfortable.

How to Prepare

Your doctor will give you clear instructions before the POEM procedure.

• Follow a liquid diet for one to two days before the procedure.
• Do not eat or drink anything for 12 hours before the procedure.
• Tell your doctor about all medicines, supplements, and allergies.
• You may need to stop blood thinners or adjust certain medicines.
• On the day of the procedure, you may receive IV antibiotics to prevent infection.
• Arrive early as instructed and arrange for a responsible adult to take you home.
• Some patients go home the same day, while others may need an overnight stay.

How is the POEM Procedure Performed?

The POEM procedure involves four major steps:

• Submucosal Injection and Mucosal Incision
• Creation of a Submucosal Tunnel
• Myotomy (Cutting the Inner Circular Muscle Fibers)
• Closure of the Mucosotomy (the entry point)

This technique can be used in treatment-naive patients as well as those who have failed previous therapies.

Duration and Recovery

• The procedure typically takes around 2 hours, depending on the operator’s expertise.
• The average hospital stay is about 2 days.
• Patients often experience symptomatic relief the very next day.
• Most patients can return to work shortly after discharge.

POEM Surgery Complications and Long-Term Outcomes

POEM is generally safe, but like any procedure, it can have complications. The most notable long-term issue is gastroesophageal reflux disease (GERD), which is usually mild and manageable with medications.

Why Choose Dr. Rela Institute of Gastroenterology?

Under the expert guidance of Dr. Mohamed Rela, a globally recognized hepatobiliary surgeon, the Institute of Gastroenterology is a cutting-edge facility committed to comprehensive, patient-centered care.

At the Institute of Gastroenterology, Dr. Rela Hospital, we have successfully performed 5 POEM procedures within 10 months, with all patients showing immediate improvement in symptoms.

What We Offer

• Personalized diagnosis and treatment plans
• Compassionate care from expert gastroenterologists in Chennai
• Multidisciplinary collaboration with radiologists, pathologists, and oncologists
• Advanced minimally invasive options, including laparoscopic and endoscopic procedures
• Preventive care and patient education to empower understanding of gastrointestinal diseases

Commitment to Innovation and Research

Our team is actively engaged in clinical research to improve treatment outcomes and introduce innovative procedures. We combine state-of-the-art technology with evidence-based medical practices to offer the best possible care to our patients.

Other Conditions Treated by POEM Surgery

Per-Oral Endoscopic Myotomy (POEM) is a safe and effective option for treating Achalasia Cardia and other esophageal motility disorders that make swallowing difficult. These include:

• Diffuse esophageal spasm (DES)
• Distal esophageal spasm
• Esophagogastric (EG) junction outflow obstruction
• Jackhammer esophagus (also called hypercontractile esophagus)
• Nutcracker esophagus (also called hypertensive esophageal peristalsis)

POEM is a safe and effective treatment option for these conditions and helps improve swallowing by relaxing tight or overactive muscles in the esophagus. With faster recovery and excellent outcomes, POEM is revolutionizing the management of esophageal motility disorders.