ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: (On-Demand)

Gyawali POEM vignettes

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This document discusses various complications of POEM (Peroral Endoscopic Myotomy), a minimally invasive procedure used to treat achalasia. The complications mentioned include esophageal candidiasis, pill esophagitis, stricture, and Barrett's esophagus. The author also discloses financial relationships with various pharmaceutical and medical device companies.<br /><br />The document presents case studies of patients who experienced dysphagia, chest pain, weight loss, and other symptoms before and after undergoing POEM. It mentions the use of botulinum toxin injection, balloon dilation, and medications such as PPIs and neuromodulators in the management of these complications.<br /><br />FLIP (Functional Luminal Imaging Probe) is mentioned as a tool used to assess treatment response and bolus retention in patients. Studies cited in the document discuss the use of FLIP in predicting symptom outcomes following POEM and in complementing high-resolution manometry (HRM).<br /><br />The document briefly mentions other factors in the management of achalasia, such as repeat LES (Lower Esophageal Sphincter) disruption, esophagectomy, and enteral feeding. It also discusses blown out myotomy (BOM), a rare complication of POEM.<br /><br />Finally, the document highlights the management of POEM failure and cites a study that discusses the use of repeat POEM in such cases.<br /><br />Overall, this document provides a brief overview of complications and management strategies related to POEM for achalasia.

Keywords

POEM

achalasia

complications

management

esophageal candidiasis

stricture

Barrett's esophagus

dysphagia

chest pain

FLIP