POEM - A Nobel Endoscopic Treatment at SPS Hospitals

Ludhiana, Punjab: Poem (Per Oral Endoscopic Myotomy) is the most recent treatment for Achalasia Cardia & Esophageal (food pipe) motility disorders. The procedure marks the beginning of a new era of endoscopic surgery.

A team of doctors led by Dr. Nirmaljeet Singh Malhi, Senior Consultant and Head , Department of Gastroenterology performed the first two POEM Procedures on 17th July, 2016 at SPS Hospitals, Ludhiana which becomes the first centre to perform such procedures in Punjab & surroundings states.

Achalasia Cardia is a condition in which patients present with complaints of difficulty in swallowing and recurrent vomiting. In many patients it becomes so debilitating that they are unable swallow anything or vomit out whatever is swallowed. Also, these patients are distressed during night due to recurrent food regurgitation in wind pipe and choking sensation. The main causes of this are tight muscles at the junction of food-pipe and stomach which does not relax, on swallowing. Till recently only balloon dilation and surgery were the two options available for these patients. Balloon dilation is associated with the risk of esophageal perforation while surgery being major procedures is associated with high cost, morbidity and prolonged hospital stay.

Dr. Umaid Hamid , Medical Superintended , SPS Hospitals added that in this era, POEM is the best available option in which using special technique and instruments, endoscope is inserted in the wall of food pipe and tight muscles are cut directly under vision. So, this is a kind of surgery which is performed completely endoscopically hence scarless, less costly and with shorter hospital stay. This procedure was performed on two such patients who were having significant difficulty in swallowing for last few years. These procedures (POEM) were uncomplicated and each procedure lasted less than two hours. The patients had no difficulty in swallowing when they were given food the next day.

Dr. Ubaid informed till date only handful of Gastroenterology centers were performing this skillful procedures in India.”Under the leadership of Dr. Nirmaljeet Singh Malhi, SPS Hospitals, Ludhiana is the first Centre to perform POEM procedures in this region”, he added.

POEM procedures is also very successful for patient who have already undergone balloon dilation/Surgery but are still symptomatic (difficulty in swallowing).Others conditions of food-pipe in which there is motility disturbance like Jackhammer esophagus( Which are difficult to treat) and non-cancerous tumor can be treated with POEM very effectively. For the correct diagnosis of esophageal motility disorders like achalasia etc, a special investigation – High Resolution Manometry (HRM) is needed. HRM is available at very few centers in northern India and SPS Hospitals is one of them.

Availability of POEM in Punjab will prove to be a boon for patients with achalasia cardia and other motility disorders. Patients now can get their disease diagnosed precisely; avoid surgery and undergo safe and effective endoscopic procedure done at very affordable cost.