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Conditions Treated
Our Approach to Peroral Endoscopic Myotomy (POEM)
Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic procedure that treats achalasia and other swallowing disorders. These disorders affect muscles in the esophagus (the tube that carries food from your mouth to your stomach).
Stanford Medicine doctors helped develop the POEM technique, which opens the esophagus to allow food to pass through. We were one of the first medical centers in the U.S. to use POEM to treat achalasia, and we are one of the highest-volume centers in the world for this innovative procedure.
What We Offer You for POEM
- Minimally invasive approach: POEM is an endoscopic procedure that involves no external incisions (cuts) or stitches. Minimally invasive procedures result in less pain, require less recovery time, and have a lower risk of complications than open surgery.
- Unmatched expertise: Stanford Medicine doctors helped develop and advance the POEM technique. Our team has advanced training, and we have performed hundreds of POEM procedures. We are one of only a handful of hospitals in the country to offer this procedure, and we are one of the highest-volume centers in the world for this technique.
- Advanced technology: Our gastroenterology (GI) surgeons are at the forefront of groundbreaking treatments. You can count on our team to deliver the highest level of care using the latest technology.
INTERESTED IN AN ONLINE SECOND OPINION?
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Visit our online second opinion page to learn more.
What Is Peroral Endoscopic Myotomy (POEM)?
Conditions Treated with POEM
Most often, doctors use POEM to treat achalasia. This condition affects the nerves and muscles that move food through your esophagus and into your stomach. Achalasia causes the muscles between your esophagus and stomach to constrict (tighten) and become too narrow. This makes it harder for food and liquids to pass through the narrow opening.
Achalasia is a type of benign esophageal disease, meaning it isn’t related to cancer. Symptoms include:
- Difficulty swallowing (dysphagia), or getting food stuck in your throat when trying to swallow
- Discomfort or pain in your chest or throat
- Regurgitation (food coming back up through your esophagus)
- Weight loss (unintentional)
In addition to achalasia, doctors sometimes use POEM to treat other types of esophageal motility disorders. These disorders make it difficult for food to move through your esophagus. For example, your doctor may recommend POEM if you have severe esophageal spasm, a disorder that causes muscles in your esophagus to contract abnormally. Untreated, esophageal spasms can progress to achalasia.
What to Expect
Before
During
After
Before the Procedure
Your care team will give you detailed instructions so you know how to prepare. You will need to follow a liquid diet for one or more days prior to the procedure. Your doctor may also adjust your medications, including blood thinner medications, before you arrive at the hospital.
During the Procedure
Doctors perform POEM in a hospital under general anesthesia, which means you are asleep during the procedure. Your anesthesiologist delivers general anesthesia through an IV and monitors you while you are asleep.
During the procedure, your doctor guides the endoscope into your mouth and down your throat. The endoscope’s camera shows real-time, magnified video of your esophagus on a monitor in the operating room. Your doctor uses the images on the screen to guide treatment during the procedure.
Using very small precision tools, your doctor makes precise cuts to the muscle inside your esophagus to open up your esophagus. When finished, the doctor removes the endoscope through your mouth.
After the Procedure
You will need to stay in the hospital for observation. Your care team will give you medication to relieve pain, control nausea, and prevent infection. While you are in the hospital, your doctor may recommend an X-ray to see images of your esophagus.
For about a week following the POEM procedure, you will need to be on a liquid-only diet. Your care team will let you know when you can start introducing soft foods and solid foods back into your diet.
To prevent or reduce acid reflux and to promote healing, your doctor may recommend a proton pump inhibitor (PPI). This medication reduces the amount of acid your stomach produces.
To monitor your recovery following POEM, your care team will recommend several follow-up appointments. You may need additional X-rays, endoscopy, or other tests to see how your esophagus muscles are working.
Before the Procedure
Your care team will give you detailed instructions so you know how to prepare. You will need to follow a liquid diet for one or more days prior to the procedure. Your doctor may also adjust your medications, including blood thinner medications, before you arrive at the hospital.
close Before
During the Procedure
Doctors perform POEM in a hospital under general anesthesia, which means you are asleep during the procedure. Your anesthesiologist delivers general anesthesia through an IV and monitors you while you are asleep.
During the procedure, your doctor guides the endoscope into your mouth and down your throat. The endoscope’s camera shows real-time, magnified video of your esophagus on a monitor in the operating room. Your doctor uses the images on the screen to guide treatment during the procedure.
Using very small precision tools, your doctor makes precise cuts to the muscle inside your esophagus to open up your esophagus. When finished, the doctor removes the endoscope through your mouth.
close During
After the Procedure
You will need to stay in the hospital for observation. Your care team will give you medication to relieve pain, control nausea, and prevent infection. While you are in the hospital, your doctor may recommend an X-ray to see images of your esophagus.
For about a week following the POEM procedure, you will need to be on a liquid-only diet. Your care team will let you know when you can start introducing soft foods and solid foods back into your diet.
To prevent or reduce acid reflux and to promote healing, your doctor may recommend a proton pump inhibitor (PPI). This medication reduces the amount of acid your stomach produces.
To monitor your recovery following POEM, your care team will recommend several follow-up appointments. You may need additional X-rays, endoscopy, or other tests to see how your esophagus muscles are working.
close After
Our Clinics
Our specialists are world-renowned experts in innovative treatments and exceptional care for swallowing disorders. As leaders in minimally invasive techniques, we are at the forefront of the latest advances and groundbreaking technology. We work together to deliver customized care and permanent symptom relief.
Redwood City, CA 94063
Phone: 650-736-5555 Getting Here