POEM is a minimally invasive, endoscopic treatment for achalasia and other swallowing disorders which can be performed without any abdominal or chest incisions. Latest studies show POEM has 98% clinical success rates.
Dr Saxena is the most experienced POEM operator in Australia. She has performed over 100 procedures and conducts workshops training other gastroenterologists and surgeons nationally and internationally. She is well published in the field and frequently invited to international conferences to give lectures on POEM.
POEM takes approximately two hours, and you are expected to stay in the hospital for an average of one-two days for monitoring.
POEM: Why It’s Performed
To treat the following diseases:
• Diffuse oesophageal spasm
• Nutcracker oesophagus
• Jackhammer oesophagus
• Recurrence of swallowing problems after prior treatment with heller myotomy or pneumatic balloon dilatation
POEM: What to Expect
Dr Saxena will discuss with you in detail during consultation.
· You may only have a liquid diet for one-two days prior to the procedure
· You may not eat or drink for 12 hours prior to your procedure. This ensures that your oesophagus is clear of food products.
We will insert an IV into your vein in order to administer fluids, anesthesia and antibiotics. You will have a general anaesthetic.
Once the procedure is finished, you will need to recover from the anesthesia in the endoscopy unit. Your doctor will discuss the procedure with you. Then you will be admitted to the hospital for monitoring and antibiotics. You will keep fasting on the night of the procedure.
You will receive an X-ray (barium swallow) the following morning and you will be permitted to drink liquids if the test comes back OK. You will advance to a soft diet and will be discharged afterward.
What is POEM:
This is a 4-step endoscopic procedure. We pass an endoscope through the mouth, create a tunnel in the oesophagus to access the muscle and then cut the muscle. We close the tunnel using endoscopic clips.
What is achalasia
It is a rare disorder. The main symptoms include
· trouble swallowing
· chest pain
· In children, can be failure to thrive (not growing)
The muscle at the bottom end of the oesophagus is called the lower oesophageal sphincter. The sphincter relaxes to allow passage of food and liquids from the oeosophagus into the stomach. In patients with achalasia, there are very high pressures in the lower oesophageal sphincter. The sphincter is tight and doesn’t relax to allow food/drinks to pass easily.
POEM: How It's Performed
Who is eligible for the procedure
Any patient with symptoms and confirmed diagnosis of achalasia or other oesophageal motility disorders. Even if you have had prior therapy with either surgery or endoscopic dilatation, you can still have a POEM.
What are expected outomes
We measure the severity of your symptoms and also the pressures in your oesophagus before your procedure (oesophageal manometry).
The severity symptom score will normalize after your procedure, you will be eating and drinking normally.
What are the benefits:
POEM replicates the surgical procedure of heller myotomy but without any abdominal or chest incisions or scars. There is shorter hospital stay and less post-procedure pain in comparison to surgery.
Patients with type III achalasia or esophageal disorders involving the higher oesophagus are more likely to benefit from POEM rather than surgery