At a glance: POEM is an incision-free endoscopic treatment for achalasia and selected swallowing disorders.
A POEM is most commonly used to treat:
- Achalasia (all types)
- Other oesophageal motility disorders, such as:
- Spastic oesophagus
- Jackhammer oesophagus
- Diffuse oesophageal spasm
Symptoms that may improve include:
- Difficulty swallowing (dysphagia)
- Regurgitation of food or fluids
- Chest discomfort after eating
- Weight loss related to poor intake
How is POEM performed?
- The procedure is done under general anaesthetic.
- A flexible tube called an gastroscope is passed through your mouth into the oesophagus.
- A small tunnel is created under the lining of the oesophagus.
- The tight muscle fibres causing the blockage are carefully cut (myotomy).
- The tunnel is sealed with tiny clips, which fall off on their own.
There are no external cuts—everything is done internally.
Photo reference: Cleveland Clinic
What are the benefits?
- Minimally invasive: no chest or abdominal incisions
- Effective symptom relief in over 90% of patients
- Short hospital stay (typically 1–2 days)
- Quicker recovery compared to traditional surgery
What are the risks?
While POEM is generally safe, potential risks include:
|
Possible Risk |
Details |
|
Gas-related effects |
Mild bloating or shoulder pain from gas used during the procedure |
|
Perforation |
Rare, but may require further treatment or surgery |
|
Bleeding |
Usually mild and managed during the procedure |
|
Infection |
Low risk, antibiotics are given to prevent this |
|
Reflux (acid heartburn) |
Common after POEM; may need long-term acid-reducing medication |
What happens after the procedure?
- You'll stay in hospital for monitoring (usually 1 night).
- Diet will be slowly restarted:
- Day 1–2: Clear fluids
- Days 3–5: Soft foods
- Gradual return to normal diet over 1–2 weeks
- You will be prescribed medication to reduce stomach acid (e.g., omeprazole) and antibiotics for 5 days
Long-term care
- Follow-up appointments are important to monitor your recovery.
- Some people may need further endoscopies or tests.
- If reflux occurs, long-term acid suppression may be needed.
- POEM does not cure achalasia, but it relieves the symptoms very effectively.
Frequently Asked Questions
Q: Will I be cured after POEM?
A: POEM can significantly improve symptoms, especially swallowing, but regular monitoring is still needed.
Q: How long is recovery?
A: Most people return to light activities within a few days and normal life within 1–2 weeks.
Q: Will I need another procedure in the future?
A: Rarely. POEM is long-lasting for most, but a small number may need additional treatment.
For more information, see Dr Cameron Schauer's website:
https://www.csgastro.co.nz/patient-information/achalasia/
https://www.csgastro.co.nz/patient-information/poem/
Frequently asked questions
Who may benefit from POEM?
It is mainly used for achalasia and selected oesophageal motility disorders after specialist assessment.
Will reflux occur after POEM?
Reflux is a recognised consequence and may require acid-suppressing medication and follow-up.
How long is recovery?
Recovery varies, but patients usually follow staged fasting and diet instructions before returning gradually to normal eating.
After your procedure
Follow the written discharge instructions supplied for your procedure. Contact the clinic or seek urgent care for severe or increasing pain, heavy bleeding, fever, persistent vomiting, breathing difficulty, fainting or other concerning symptoms.
Book or refer
For appointments or referral information, visit our endoscopy referral and booking page.