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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.
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.
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.
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 ...
achalasia; Zenker's diverticulum; a barium swallow may be performed before endoscopy to help identify abnormalities that might increase the risk of perforation at the time of endoscopy. If achalasia suspected an upper endoscopy is required to exclude a malignancy as a cause of the findings on barium swallow. Manometry is performed next to confirm.
At this time, due to the lack of evidence, there is no consensus on the ideal temperature ranges, time frames, application methods, or patient populations when using ice on a soft tissue injury. [16] Most studies use icing protocols of intermittent 10-20 minute applications, several times a day for the first few days following an injury. [7]
Achalasia is a major exception to usual pattern of dysphagia in that swallowing of fluid tends to cause more difficulty than swallowing solids. In achalasia, there is idiopathic destruction of parasympathetic ganglia of the Auerbach's (Myenteric) plexus of the entire esophagus, which results in functional narrowing of the lower esophagus , and ...