Non-Surgical Esophageal Myotomy for Achalasia and Swallowing Difficulty

Introduction

Patients with achalasia and swallowing difficulties face significant challenges in eating and drinking, affecting their quality of life. Modern medicine has introduced non-surgical techniques to address this issue, including esophageal myotomy.

What is Achalasia and Swallowing Difficulty?

Achalasia is a disorder that affects the esophageal muscles, preventing them from relaxing properly to allow food to pass into the stomach. This condition causes difficulty swallowing, chest pain, acid reflux, and weight loss.

Why is Esophageal Myotomy Needed?

The procedure aims to reduce pressure in the esophagus and facilitate food passage by making a small incision in the lower esophageal sphincter, the muscle that prevents food from returning to the esophagus from the stomach.

Modern Non-Surgical Myotomy Techniques

POEM (Peroral Endoscopic Myotomy) via Gastroscopy

A submucosal tunnel is created using an endoscope inserted through the mouth.
The lower esophageal sphincter and esophageal muscles are cut to reduce pressure at the esophagus-stomach junction, making swallowing easier.

Benefits of Non-Surgical Myotomy

Natural opening approach: The procedure is done through the mouth without external incisions.
More effective than balloon dilation: Unlike balloon dilation, which carries a risk of esophageal perforation and requires multiple sessions, POEM is a one-time procedure with greater safety and effectiveness.
Faster recovery: Most patients can be discharged the day after the procedure.

When Should You Consider This Technique?

Consult your doctor if you experience difficulty swallowing, pain while swallowing, weight loss, food or liquid regurgitation through the nose or mouth, or persistent chest pain. Your doctor may recommend specific tests before proceeding with the procedure.

Potential Risks

Esophageal perforation: Although rare, perforation can occur.
Bleeding: Mild bleeding may happen post-procedure.
Symptom recurrence: Some patients may need a repeat procedure in the future.