If you have an esophageal motility disorder or gastroparesis, your doctor may suggest one of two minimally invasive surgery options — esophageal peroral endoscopy myotomy (POEM) or gastric peroral endoscopy myotomy (G-POEM).
Both POEM and G-POEM procedures offer an alternative to traditional surgeries.
Discover how we use POEM and G-POEM at our Advent Health Center for Interventional Endoscopy (CIE) and what you can expect before, during and after.
Esophageal Motility Disorders
POEM is an established third space endoscopic procedure that treats esophageal motility disorders. This group of illnesses affects the esophagus and how food moves from your mouth to your stomach.
Common types of esophageal motility disorders include:
- Achalasia
- Diffuse esophageal spasm
- Esophagogastric junction outlet obstruction (EGJOO)
- Jackhammer esophagus
If you have one of these disorders, you may have trouble swallowing or often regurgitate food. It’s common to feel like food is stuck in your throat or chest, and you may experience nausea, heartburn, chest pain or weight loss.
POEM Procedure
At AdventHealth CIE, we perform the POEM procedure on some patients with esophageal motility disorders. POEM can be a helpful option if you have symptoms that won’t go away. It is a minimally invasive procedure that is as effective as traditional surgery but with much faster recovery.
The procedure is like an upper endoscopy. Your doctor, an advanced endoscopist, has special training in the POEM procedure.
On the day of the procedure, you will receive general anesthesia, so you’ll be asleep. Then, your doctor moves a thin, flexible endoscope down into the throat. There, they make a superficial incision within the esophagus. The small opening helps get to the part of the esophagus called the esophageal sphincter.
Your doctor completes a myotomy, which is a permanent cut to the esophageal muscle. This cut makes it easier for food to get into the stomach from the esophagus.
Overall, the procedure takes 60-90 minutes.
Gastroparesis
G-POEM is an endoscopic technique that treats some patients with gastroparesis.
Gastroparesis is a motility disorder in the digestive tract. It makes the stomach empty slowly, preventing food from moving into small intestine. With gastroparesis, you may have these symptoms:
- Abdominal pain
- Bloating
- Feeling full after eating a small meal
- Heartburn
- Nausea
- Vomiting
G-POEM Procedure
The G-POEM procedure is like the POEM procedure, except it focuses on the stomach.
After you receive general anesthesia to put you to sleep, your advanced endoscopist moves the endoscope down the throat and into the stomach, where they make a superficial incision. The small opening helps get to the bottom of the stomach, called the pyloric sphincter.
Your doctor completes a pyloromyotomy, which is a permanent cut to the pyloric sphincter. This cut makes it easier for food to pass beyond the stomach and into the small intestine.
Similar to POEM, G-POEM takes about 60-90 minutes.
Before, During and After POEM and G-POEM Procedures
Your care team will give you instructions to follow before your procedure. Make sure you tell them about any medications you take, so they can adjust them as needed. You’ll want to have only clear liquids for at least two days beforehand, and nothing to eat or drink for eight hours before the procedure.
POEM and G-POEM procedures usually are outpatient, but your doctor will determine the need for overnight stay for observation, if necessary, following the procedure.
After your procedure, you may receive nausea or pain medication, but most patients don’t have any symptoms within 24-48 hours. You’ll take some antibiotics for a short time to prevent infection.
Your doctor may order imaging tests to check the surgical area before you start eating again. For the first three days after the procedure, you’ll be on a soft diet. You can advance your diet based on how you tolerate food and your doctor’s direction.
Personalized Endoscopy Treatments
Our doctors at AdventHealth CIE make sure you receive the best treatment for your specific condition. As one of the region’s only complex endoscopy centers, we use interventions that provide an alternative to more invasive surgeries.
To schedule an appointment or see if POEM or G-POEM is right for you, call the center at
Call813-615-7028.
