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Physician Update - POEM to Ease Esophageal Passage
Physician Update Fall 2014
POEM to Ease Esophageal Passage
Date: November 12, 2014
To register for our new online clinician resource Clinical Connection and hear Mouen Khashab discuss the use of POEM in his practice, visit bit.ly/clinicalconnection.
For patients like Connie Mills, achalasia can take over. The motility disorder affecting one in 100,000 people causes the lower esophageal sphincter to tighten, preventing the propulsion of food to the stomach. Patients report trouble swallowing, chest pain, weight loss and regurgitation.
Mills learned to carry paper cups to catch food backflow, and her ability to eat meat had dwindled to “paper-thin turkey in a lot of gravy.” And, she says, “cold liquids would literally shoot from my mouth.”
In 2012, Mills became the first patient at Johns Hopkins and one of a handful in the United States to be treated with a newer procedure called peroral endoscopic myotomy (POEM). During the 90-minute operation, gastroenterologist Mouen Khashab uses an endoscope tipped with a needle-knife to cut the mucosa 5 inches above the sphincter, then tunnel through the esophageal wall to remove the inner circle of muscle from the lower part of the esophagus and upper part of the stomach. The procedure relieves tightness, once again allowing the passage of food to the stomach. All that’s needed to close the esophageal lining are a few endoscopic clips, and many patients can leave the hospital after just one night.
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