ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: LIVE and Virtual

Video Transcription

Video Summary

In the video, Dr. Gawale and the speaker discuss several cases involving patients who have undergone the Peroral Endoscopic Myotomy (POEM) procedure for conditions such as esophageal outflow obstruction and achalasia. They emphasize the importance of long-term care and management of these patients, as they often face challenges following the procedure. In one case, a 50-year-old female who underwent the POEM procedure continued to struggle with solids and was unable to eat or drink as expected. The speaker suggests managing expectations and focusing on diet and lifestyle counseling to help improve the patient's condition. They also provide specific tips and tricks such as drinking water before, during, and after meals, chewing food thoroughly, and avoiding lying down after eating. In another case, a 70-year-old male who had previously undergone a myotomy continued to experience symptoms and was diagnosed with reflux esophagitis and absent contractility. The speaker discusses the importance of weight management and suggests modifying diet and lifestyle factors to improve symptoms. They also mention the possibility of considering an anti-reflux procedure if medication alone is not effective. The video concludes with a case involving a 28-year-old male with achalasia and residual spasms following a Heller myotomy. The speaker discusses the use of Botox trials to recreate the patient's previous positive response and ultimately recommends a completion myotomy. Overall, the video highlights the challenges faced by patients post-POEM procedure and provides insights and strategies for managing these cases.

Keywords

Peroral Endoscopic Myotomy

esophageal outflow obstruction

achalasia

long-term care

diet and lifestyle counseling

reflux esophagitis

weight management