Peroral endoscopic myotomy (POEM) is an advanced endoscopic treatment method used for achalasia and other esophageal diseases. With the oral endoscopic myotomy (POEM) method, used in several centers around the world, problem muscles are cut by entering through the mouth as if a normal endoscopy were being performed.
In what diseases is POEM used?
This is a method of treating achalasia disease. Achalasia is a rare disease that makes it difficult for food and fluid to pass through the esophagus to the stomach.
Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. The food then collects in the esophagus, sometimes ferments, and goes back into the mouth with a bitter taste. Sometimes this condition is mistakenly perceived as gastroesophageal reflux disease (GERD). In achalasia, the food comes from the oesophagus, whereas in GERD it returns from the stomach.
There is no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But the symptoms can usually be managed with endoscopy or with minimally invasive surgery.
Symptoms:
Symptoms of achalasia usually appear gradually and worsen over time. Signs and symptoms may include:
- Inability to swallow (dysphagia), which may feel like food or drink stuck in the throat
- Regurgitation of food or saliva
- Heartburn
- Bad breath
- Orig.
- Chest pain that comes and goes
- Coughing at night
- Pneumonia (from aspiration of food into the lungs)
- Weight Loss
- Vomiting
Reasons:
The exact cause of achalasia is unknown. Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories as to what causes this - viral infection or autoimmune reactions are suspected. Very rarely, achalasia can be caused by an inherited genetic disease or infection.
How is POEM applied?
After the diagnosis of achalasia disease, with some endoscopic methods, the muscles in the esophagus are intervened, allowing the patient to eat normally again.
What are the distinctive features of the POEM method?
POEM is one of the most advanced endoscopic treatment methods in the world. The procedure is performed endoscopically, there are no incisions on the body and the patient is discharged in a short time. Patients begin eating 1 day after the POEM procedure and can return to a normal lifestyle as early as day 2. The procedure takes approximately 1-1.5 hours. The long-term success rate is over 90%. Since the complication rate is very low, it is currently the first preferred method of treatment for achalasia disease worldwide.
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