What is peroral endoscopic myotomy (POEM)? 

Peroral endoscopic myotomy, or POEM, is a minimally invasive procedure used to treat achalasia, a rare condition that makes it difficult to swallow. Achalasia is a rare motility disorder of the esophagus, the tube in which food travels to the stomach. POEM does not require external incisions, so there is no visible scarring.

What does the POEM procedure look like?

The POEM procedure is performed by CHOP’s trusted pediatric experts in pediatric gastroenterology and anesthesia. They work together to ensure a successful operation to treat your child’s condition and manage pain, all while prioritizing their safety.

Using an endoscope — a flexible tube with a camera — a pediatric gastroenterologist enters the lower esophagus through the mouth and separates the overactive muscles to relieve obstruction and improve swallowing. Achalasia is a rare motility disorder of the esophagus, the tube in which food travels to the stomach. This procedure, performed alongside an anesthesiologist, results in less discomfort and a faster recovery compared to traditional surgery.

What can I expect following the POEM procedure?

Following the procedure, your child will typically need to stay in the hospital for up to 24 hours for observation. For post-procedure testing purposes, your child must follow a liquid diet overnight. The next day, your child will be given liquid barium to swallow, and an X-ray will be performed to confirm the esophagus is healing properly.   

Once your child goes home, they should see their gastroenterologist within a week for further evaluation and care. Your child’s provider may order additional studies as needed. 

Why choose POEM?

POEM offers a highly effective alternative to surgical approaches, such as the Heller myotomy, while delivering comparable results. Its minimally invasive nature results in less pain, faster recovery and no visible scars for eligible children. 

Children typically need to be at least 2 years old to be considered for POEM. However, eligibility is determined on a case-by-case basis, depending on your child’s overall health, the severity of their condition and the assessment by their medical team.