Peroral Endoscopic Myotomy(POEM)


Achalasia can be overlooked or misdiagnosed because it has symptoms similar to other digestive disorders. To test for achalasia, your doctor is likely to recommend:

  • Esophageal manometry
  • X-rays of your upper digestive system
  • Upper endoscopy

Nonsurgical treatment

  • Pneumatic dilation
  • Botox (botulinum toxin type A)
  • Medication


  • Heller myotomy
  • Peroral endoscopic myotomy (POEM)


In the POEM procedure, the surgeon uses an endoscope inserted through your mouth and down your throat to create an incision in the inside lining of your esophagus. Then, as in a Heller myotomy, the surgeon cuts the muscle at the lower end of the esophageal sphincter. POEM may also be combined with or followed by later fundoplication to help prevent GERD. Some patients who have a POEM and develop GERD after the procedure are treated with daily oral medication.