What is Peroral Endoscopic Myotomy (POEM)?
Peroral Endoscopic Myotomy (POEM) is an advanced, minimally invasive endoscopic procedure used to treat swallowing disorders caused by loss of neurons in the esophagus muscles. The esophagus is the food pipe that connects the mouth to the stomach, and in this condition it’s muscles fail to relax properly, making it difficult for food and liquids to pass down.
During POEM, a gastroenterologist inserts a thin, flexible tube (endoscope) through the mouth to reach the esophagus. A small incision is made in the mucosal lining of the esophagus, enters the submucosal space and is extended from the esophagus into the stomach. Then the tight non expanding muscles are cut for a short distance in the esophagus and the stomach. Then the mucosal opening is closed with clips
Since POEM is performed entirely through the mouth, there are no external cuts or scars, making it a safer and faster alternative to traditional surgery.
When is POEM Recommended?
POEM is usually recommended for patients suffering from:
- Achalasia – a rare condition where the lower esophageal sphincter (LES) does not relax, leading to difficulty swallowing, regurgitation of food, and chest discomfort.
- Esophageal motility disorders such as:
- Diffuse esophageal spasm (irregular, painful contractions of the esophagus)
- Jackhammer esophagus (excessively strong contractions causing swallowing difficulty)
Doctors recommend POEM when medicines or other treatment methods do not provide adequate relief. It has proven to significantly improve swallowing and overall quality of life.
How is achalasia cardia diagnosed ?
This condition is diagnosed through upper GI endoscopy and is confirmed by esophageal manometry and timed barium swallow test
How is POEM Different from Conventional Treatments?
Compared to traditional surgical approaches, POEM offers several unique advantages:
- Minimally invasive – performed through the mouth without major cuts on the chest or abdomen.
- Faster recovery – patients usually return to routine activities within a few days.
- No external scars – since the procedure is endoscopic, there are no visible marks on the body.
- Targeted treatment – focuses only on the problem-causing muscles of the esophagus.
- High success rate – global studies show over 90% success in reducing swallowing problems and improving quality of life.
At Daya General Hospital, Thrissur, our experienced gastroenterology team is equipped with the latest endoscopic technology to perform POEM safely and effectively.
Life After POEM
Most patients notice immediate improvement in swallowing after the procedure. Recovery is quick, and normal daily activities can usually be resumed within a few days. Heavy physical exertion may need to be avoided for a short period as advised by the doctor.
Benefits after POEM include:
- Easier swallowing of food and liquids
- Reduced chest pain and regurgitation
- Better nutrition and improved overall health
- Long-term relief from symptoms with minimal complications
By choosing POEM at Daya General Hospital, patients can expect personalized care, advanced technology, and improved quality of life with a safe, minimally invasive approach.
Frequently Asked Questions (FAQs) on POEM
1. What is the POEM procedure used for?
POEM (Peroral Endoscopic Myotomy) is mainly used to treat swallowing problems caused by conditions like achalasia and other esophageal motility disorders. It helps relax tight esophagus muscles so that food and liquids can pass easily into the stomach.
2. Is POEM a surgery?
POEM is a minimally invasive endoscopic surgery procedure, not a laparoscopic or open surgery. It is performed through the mouth using a flexible scope, so there are no external cuts or scars.
3. How long does the POEM procedure take?
On average, POEM takes about 60 to 90 minutes, depending on the patient’s condition. Most patients can go home within a couple of days.
4. How safe is the POEM procedure?
POEM has been proven to be safe and effective worldwide, with success rates above 90%. At Daya General Hospital, the procedure is performed by highly experienced gastroenterologists using advanced technology.
5. What is the recovery time after POEM?
Most patients can return to their normal routine within a few days after the procedure. Heavy exercise or strenuous activities should be avoided for a couple of weeks, as advised by the doctor.
6. Will I have scars after POEM?
No. Since POEM is performed entirely through the mouth, there are no external scars on the body.
7. Who should consider POEM treatment?
Patients with achalasia cardia diagnosed by endoscopy, manometry and timed barium swallow should undergo POEM
8. Is POEM available in Thrissur?
Yes. Daya General Hospital, Thrissur is among the few hospitals offering this advanced treatment in Kerala, with an expert gastroenterology team trained in POEM.
9. How successful is POEM compared to traditional surgery?
POEM has shown equal or higher success rates than conventional surgery, with the added benefits of faster recovery, less pain, and no scars.
