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Acid Reflux causes and Treatment

Peroral Endoscopic Myotomy For Achalasia (POEM)

Peroral Endoscopic Myotomy For Achalasia (POEM)


Achalasia is a serious condition that affects
your esophagus. The lower esophageal sphincter (LES) is a
muscular ring that closes off the esophagus from the stomach.If you have achalasia, your LES fails to open
up during swallowing, which it’s supposed to do. Most achalasia treatments involve your LES.Several types of treatment can either temporarily
reduce your symptoms or permanently alter the function of the valve Pneumatic dilation typically involves inserting
a balloon into your esophagus and inflating it The balloon disrupts the esophageal muscle.The treatment may have to be repeated every
few years to ensure long-term results. Another option is Botox to relax the sphincter.This injection is effective for 3-6 mnths. A newer option Peroral endoscopic myotomy
(POEM) is one of the alternative treatment for achalasia In an endoscopic way with injection a submucosal tunnel is opened and then submucosal tunnelling beyond gastroesophageal junction A small incision is
made in the innermost layer of the esophagus (the mucosa). we are dividing the circular muscle bundles. In the lower esophagus, the endoscopist cuts
the muscle fibers of the lower esophageal sphincter. Now there is a video here,we open a submucosal thunnel ,we cut the circular muscles and we reach to esophagus and then we make closure with the clips

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