POEM for Achalasia — Long-Term Follow-Up

Although achalasia is uncommon, primary care physicians occasionally will encounter cases among patients who present with dysphagia and regurgitation. Traditional treatment options are pneumatic dilation and Heller myotomy, but an endoscopic procedure — peroral endoscopic myotomy (POEM) — has emerged as a less-invasive alternative to Heller myotomy (NEJM JW Gastroenterol Feb 2020 and N Engl J Med 2019; 381:2219).

This single-center report describes outcomes for 100 achalasia patients who had at least 4 years of follow-up (mean, 55 months) after undergoing POEM. On a standardized, 12-point scale that assesses severity of four symptoms (i.e., dysphagia, regurgitation, chest pain, and weight loss), mean score decreased from 7 (prior to POEM) to…