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

Video Transcription

Video Summary

In this video, Dr. Vani Konda presents a pre-course presentation on patient selection and the Chicago Classification 4.0 for the POEM Oscopist. She discusses the overall assessment needed for diagnosing esophageal motility disorders, updates to the Chicago Classification 4.0, and the implications for interpreting motility studies. Dr. Konda emphasizes the importance of considering conditions that mimic achalasia, such as gastroesophageal reflux disease, eosinophilic esophagitis, and malignancy. She highlights the need for an endoscopic examination to establish non-obstructive dysphagia and the importance of taking manometric evidence in the overall clinical context.<br /><br />Dr. Konda explains that obtaining a detailed history and performing physical examinations, endoscopy, high-resolution manometry, barium studies, and functional luminal imaging probe are essential to diagnose esophageal motility disorders. She discusses the different types of achalasia and their associated characteristics, as well as the importance of evaluating the behavior of the lower esophageal sphincter.<br /><br />The video also covers the use of supportive testing, including time-barium esophagram and FLIP, in inconclusive cases. Dr. Konda highlights the importance of understanding the spectrum of diagnostic certainty when making decisions regarding intervention. She discusses different treatment options for esophageal motility disorders, such as medications, Botox injection, pneumatic dilation, laparoscopic heller myotomy, and peroral endoscopic myotomy.<br /><br />In conclusion, Dr. Konda emphasizes the importance of considering symptoms, dysfunction, and testing for multiple modalities to make a diagnosis and create a treatment plan for esophageal motility disorders. She encourages using updated protocols and appreciating tailored decision-making approaches based on the severity and extent of dysfunction.

Asset Subtitle

Vani Konda, MD

Keywords

esophageal motility disorders

Chicago Classification 4.0

achalasia

diagnosis

treatment options

endoscopic examination

manometric evidence