A very effective treatment for achalasia, Zenker’s diverticulum and gastroparesis. Compared to surgery, POEM has fewer risks and is more effective. Patients often go home the day after their procedure with little or no pain at all. POEM uses slightly different approaches for each condition being treated:
For people living with swallowing disorders, feeling a choking sensation when they eat or drink is a common occurrence. But thanks to a newer, less invasive treatment option, people can find relief from these troublesome symptoms and gain a better quality of life. Read more.
The swallowing disorder, more commonly known as achalasia, is a condition in which the sphincter muscle between the esophagus and stomach does not function properly. As a result, food cannot pass through the esophagus to the stomach. This causes difficulty swallowing, regurgitation and vomiting, and even chest pain during meals. It’s also linked to weight loss and malnutrition.
The condition can affect people ages 2 to 82, and up until recently, there weren’t many options for treatment.
Dr. Michael Karasik, a gastroenterologist affiliated with Hartford Hospital, is one of only a handful of doctors in the country offering a procedure called POEM, which stands for Peroral Endoscopic Myotomy.
In the POEM procedure, a flexible tube called an endoscope is passed through the mouth to the esophagus. From there, it enters the middle wall layer to create a tunnel down to the sphincter muscle and into the stomach wall. Once this tract is made, the underlying muscle layer can be safely cut to eliminate the spasm causing the patient’s symptoms and allow food to more easily pass from the esophagus to the stomach.
“The greatest advantage for the patient is there is no external cutting. It’s less invasive than surgery, there’s less scarring, and people who are not candidates for surgery or have failed surgery can still be a good candidate POEM,” said Karasik.
Patients are often discharged from the hospital the very next day and with little to no pain. While they need to restrict their diet immediately following the procedure, they are able to eat regular food again in about two weeks.
Only a handful of hospitals offer this less-invasive approach to treating swallowing disorders. The technique originated in Japan and it has been performed in the United States for the last few years.
At Hartford Hospital, Dr. Karasik also performs variations of the POEM procedure (Z-POEM) for patients with difficulty swallowing due to a Zenker’s diverticulum (where the problem occurs at the sphincter at the top of the esophagus, as opposed to the bottom). Another variation (G-POEM) can help patients living with gastroparesis by treating the pyloric sphincter. Gastroparesis is a condition affecting the stomach muscles that impacts the stomach’s ability to empty.
“We want people to know about this new approach, and that there is hope for a better quality of life,” said Karasik.