Peroral Endoscopic Myotomy (POEM) for Achalasia Cardia: A Case Report
A minimally invasive endoscopic treatment for progressive dysphagia caused by achalasia cardia.
A ~30-year-old patient presented with progressive dysphagia, regurgitation, weight loss, and chest discomfort. Diagnostic evaluation confirmed achalasia cardia. The patient underwent Peroral Endoscopic Myotomy (POEM), a minimally invasive endoscopic procedure. Post-procedure, the patient showed significant symptomatic improvement with early recovery, demonstrating POEM as an effective treatment for achalasia.
Case Presentation & Intervention
A patient around 30 years of age presented with several months of worsening dysphagia, characterized by a sensation of food sticking in the chest, regurgitation of undigested food, weight loss, and chest discomfort.
Diagnostic workup included upper gastrointestinal endoscopy, high-resolution manometry, and barium swallow, which confirmed the diagnosis of achalasia cardia. The condition was attributed to failure of relaxation of the lower esophageal sphincter, leading to impaired passage of food into the stomach.
The patient underwent Peroral Endoscopic Myotomy (POEM), a minimally invasive endoscopic procedure performed via the oral route. The technique involves precise myotomy of the dysfunctional esophageal muscle to relieve obstruction and restore normal food passage, without external incisions.
Outcome
The patient had an uneventful recovery, with discharge after a short hospital stay. At follow-up, there was marked improvement in swallowing and overall symptoms. The patient continues under periodic monitoring for long-term outcomes.
Conclusion
POEM is a safe and effective minimally invasive treatment for achalasia cardia, providing significant symptomatic relief with rapid recovery and no external scarring.
Dr. Parvesh Kumar Jain
Consultant, Medical Gastroenterologist
Apollo Speciality Hospital, Jayanagar