Use of Endoflip and POEM for Effective Diagnosis and Treatment of Achalasia

Oct. 8, 2020

Physicians at HM have expertise in using advanced technology to diagnose and treat achalasia, a swallowing disorder.

Using the EndoFlip device, we can access a complete and detailed view of the gastroesophageal junction (GEJ) for our patients with achalasia. Through this minimally invasive technique, our specialists can measure motility, distensibility, diameter and the cross-sectional area around the GEJ, providing for more accurate diagnoses of achalasia.

Achalasia is caused by damage to the nerves in the esophagus and stomach, making it difficult for food and liquid to pass from the esophagus into the stomach. The disorder is difficult to diagnose because symptoms often mimic other diseases, and manometry catheters alone often cannot pass the sphincter to gain clear sight into crucial areas. We use the EndoFlip for diagnosis of disease and also in some surgeries as a critical guide to therapy.

To treat achalasia, our surgeons access the esophagus through the mouth using a flexible endoscope. Peroral endoscopic myotomy (POEM) provides our patients with a less invasive treatment for achalasia combined with the durability of surgical myotomy. A small incision is made in the mucosal lining of the esophagus and into the esophageal wall, where a myotomy is performed. By loosening the muscles on the side of the esophagus, the lower esophageal sphincter (LES) and the upper part of the stomach, food and water is able to pass through to the stomach. Patients are often discharged without the need for pain medicine and typically spend only one night in the hospital.