All you need to know about POEM Procedure

All you need to know about POEM ProcedureDr. Kapil Sharma. Director& Founder -of GastroQure Liver, GI & Endoscopy clinic Kalkaji New Delhi

Those are presented with swallowing difficulty for the POEM procedure after doing a thorough physical examination for dysphagia treatment based on the following investigation:

* Upper GI endoscopy – It is a non-surgical procedure used to find out the disease and conditions related to difficulty swallowing Like Achalasia cardia, Epiphrenic diverticulum and Zenker diverticulum, Eosinophilic Esophagitis, schatzki B ring, Peptic stricture, Fungal and Viral Esophagitis, submucosal and mucosal Tumour of Esophagus

* Esophageal manometry – It is a test to assess the motor function of the esophageal body and upper and lower esophageal sphincter. By doing this test doctor can differentiate the type of achalasia cardia type 1, type 2, and type 3. It also diagnoses the spastic esophageal motility disorder.

* X-ray barium swallow – It is a radiology examination of the esophagus (Food Pipe).

Dr Kapil Sharma has performed more than 200 Per oral endoscopic myotomy (POEM) for Achalasia Cardia. He said that esophageal obstruction caused by hypertensive Lower oesophageal sphincter is relieved immediately after the procedure However Post procedure movement of the Esophagus called as peristalsis will come to its normal function after several months. Symptoms disappear as Food passes as normal to the stomach from the Oesophagus

What to expect before the POEM procedure?

Patients need to follow the preparations as advised by the primary care doctor before a POEM operation.

Patients must follow a liquid diet and plenty of warm water for at least 48 hours to make the Esophagus and stomach clear so that the procedure can happen smoothly. Simultaneously, patients must be fasting for 12 hours before the procedure.
if they have any heart conditions or diabetes discuss before taking medicines for pre-existing disease.

After hospitalization, the doctor will do a thorough evaluation and physical examination of the patients to make them ready for the procedure.

What are the outcomes of the POEM procedure?

Mostly, patients will take 7 to 10 days of recovery time from POEM surgery and start a normal routine.

What are the side effects of POEM surgery?

After POEM surgery, most of the side effects are for a very short time, patients may experience these side effects for a maximum of 3 to 4 days:

* Chest pain and discomfort
* Sore throat
* Heartburn
* Gastroesophageal Reflux

Major adverse effects such as leaks, delayed bleeding, and delayed mucosal perforations are uncommon, patients can overcome minor side effects very fast.

What are the complications of POEM procedure?
The complications of the POEM procedure are extremely low during and after the procedure. The doctor monitors the patient to avoid these complications:

* Bleeding
* Mucosotomy
* Pneumothorax
* Pneumoperitoneum
* Subcutaneous emphysema
* Gastroesophageal reflux

Is there any food restriction immediately after the POEM procedure?
Patients are required to follow a liquid and soft diet that will help the Esophagus muscle to heal fast and regain its natural functions. After 48 to 72 hrs hours patients can have normal food as advised by the doctor.

What is the success rate of the POEM procedure?
As per the recent research data, it’s been recorded 92 to 95 % success rate of POEM surgery, in patients who are reported with severe symptoms of swallowing difficulty.

What is the cost of the POEM procedure in India?
POEM surgery cost in India ranges from Rs. 1,25,000 to Rs. 2,15,000 (Rupees one lakh twenty-five thousand to two lakh fifteen thousand). However, the cost of the POEM procedure in India may vary depending on the different private hospitals in different cities

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