What is POEM and what condition is it used for?

• A. Peroral endoscopic myotomy; used to treat achalasia and other spastic esophageal motility disorders.
• B. Partial organ endoscopic methylation
• C. Postoperative endoscopic mucosal resection
• D. Pyloromyotomy endoscopy

Answer: (A)

POEM stands for Peroral Endoscopic Myotomy, a minimally invasive endoscopic procedure that relieves obstruction at the lower esophageal sphincter by cutting the circular muscle fibers. It’s primarily used to treat achalasia, where the LES fails to relax and bolus passage is blocked, and it can also be effective for other spastic esophageal motility disorders. The technique involves making a small mucosal entry, creating a submucosal tunnel to the LES, performing the myotomy of the muscle, and then closing the entry. The other options refer to different procedures or concepts (for example, a mucosal resection, or a pyloromyotomy) and do not describe the treatment approach for achalasia.