Who is eligible for POEM?
The procedure was initially performed for Achalasia, however it is now also used to successfully treat patients with other spastic esophageal disorders such as Diffuse Esophageal Spasm and Jackhammer Esophagus
What is the advantage of POEM over current conventional treatment?
- POEM is an “incision-less” procedure leaving no scars as it is performed from within the esophagus.
- It offers quicker recovery time than the standard surgical procedure
- Allows for more flexibility procedurally allowing easier performance in more complex and difficult cases
Who can perform the POEM procedure?
Highly trained Gastroenterologist or Surgeons
Is the POEM procedure available in Canada?
Yes. Currently, there are a handful of centers in North America that perform POEM. There are currently two North Americans physicians that have completed a formal one year training fellowship in Japan with the pioneer of POEM (Dr. Haruhiro Inoue). One of which is a Gastroenterologist at Queens University in Kingston, Ontario and the other is a surgeon in Cleveland, Ohio.
How effective is the POEM procedure?
The procedure is effective in over 90% of patients with providing symptom relief from achalasia
What are the potential adverse effects of POEM?
- Excessive gas (carbon dioxide from insufflation) in the abdominal cavity requiring decompression (managed during POEM using a small needle to decompress the abdomen without clinical consequences).
- A perforation (hole) in the mucosa of the esophagus (can be closed with the tiny clips used to close the entry site, again without clinical consequence).
What are the potential serious adverse effects of POEM?
There have been a few case reports of serious adverse events which include; serious infections, bleeding requiring transfusion and aspiration pneumonia.
I had surgery and/or treatment before for achalasia, can I still have the POEM procedure?
Yes. The POEM procedure has been performed successfully with excellent results in patients with achalasia who have had previous surgical and endoscopic treatments (Heller myotomy, balloon dilation, and/or Botox injection)
When can I eat after the procedure?
After the procedure you cannot have anything to eat or drink on the same day. The following day you will have another exam of your esophagus with an endoscopy and an X-ray. Once this are confirmed to be normal, you will start on liquids. Generally, you will resume a normal diet within 4 days.
What can I expect to feel after the procedure?
You may experience chest soreness or discomfort after the procedure which is normal and is a result of cutting the abnormal muscle. This will subside within 2-3 days. Also, it’s not uncommon to have a fever within the first 24-48 hours, this will also resolve within 1-2 days and is a result of the inflammatory response to the procedure.
How long will I be in the hospital?
The length of stay will vary across centers, but our patients are typically sent home after 1 day
A printable version of the Frequently Asked Questions about POEM can be downloaded here