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The per-oral endoscopic myotomy, or POEM, is a minimally invasive surgical procedure for the treatment of achalasia wherein the inner circular muscle layer of the lower esophageal sphincter is divided through a submucosal tunnel. [1] This enables food and liquids to pass into the stomach, a process that is impaired in achalasia.
Laparoscopic myotomies have shorter recovery times, reduced postoperative pain, and lower chances of complications. Endoscopic Myotomy (POEM): Peroral endoscopic myotomy, or POEM, is a recent technique for achalasia that is entirely endoscopic, eliminating the need for external incisions.
Heller myotomy is a surgical procedure [1] in which the muscles of the cardia (lower esophageal sphincter or LES) are cut, allowing food and liquids to pass to the stomach.It is used to treat achalasia, a disorder in which the lower esophageal sphincter fails to relax properly, making it difficult for food and liquids to reach the stomach.
A new endoscopic therapy for achalasia management was developed in 2008 in Japan. [35] Per-oral endoscopic myotomy or POEM is a minimally invasive type of natural orifice transluminal endoscopic surgery that follows the same principle as the Heller myotomy. A tiny incision is made on the esophageal mucosa through which an endoscope is inserted.
If symptoms are severe or persistent, peroral endoscopic myotomy (POEM) may be offered. [2] Pneumatic dilation may be used for persistent symptoms in the absence of identified causes of mechanical obstruction. [2] Botulinum toxin may be considered, [5] especially for individuals who are unlikely to tolerate surgery. [2]
Nutcracker esophagus is one of several motility disorders of the esophagus, including achalasia and diffuse esophageal spasm. It causes difficulty swallowing with both solid and liquid foods, and can cause significant chest pain; it may also be asymptomatic. Nutcracker esophagus can affect people of any age but is more common in the sixth and ...
Dysphagia to liquids, in particular, is a characteristic of achalasia. Other symptoms of achalasia include regurgitation, night coughing, chest pain, weight loss, and heartburn. The combination of achalasia, adrenal insufficiency, and alacrima (lack of tear production) in children is known as the triple-A (Allgrove) syndrome.
Diffuse esophageal spasm (DES) is a motility disorder characterized by recurrent episodes of chest pain or dysphagia as well as nonpropulsive (tertiary) contractions on radiographs. [ 5 ] Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain.