Achalasia cardia is a condition where the muscle at the bottom of the esophagus doesn't relax properly. Dr. Pavan Addala was the first surgeon in Andhra Pradesh to perform POEM, in 2016.
Achalasia happens when the lower esophageal sphincter fails to relax normally during swallowing. Food and liquid build up rather than passing through smoothly. It's a relatively rare condition, often not the first diagnosis considered.
Diagnosis typically involves a barium swallow study, upper endoscopy, and esophageal manometry, the most definitive test for confirming diagnosis and subtype.
Options include medication (limited effectiveness), balloon dilation, laparoscopic Heller myotomy, and POEM. POEM and Heller myotomy are considered similarly effective, with POEM offering no external incision.
POEM cuts the tight muscle fibers entirely through an endoscope passed through the mouth. Dr. Addala presented a master video on the technique at APASICON 2017, and trained other surgeons at Asia Pacific Digestive Week, Kolkata, 2019.
Recovery is typically faster than surgical myotomy — often one to two days hospital stay, with gradual return to normal diet over the following weeks.
POEM is generally well-tolerated, though as with any procedure working within the esophageal wall, risks include bleeding, infection, and, less commonly, reflux developing afterward since the procedure affects the same valve mechanism that normally prevents it. This is discussed as part of pre-procedure counselling and is manageable with follow-up care.
Achalasia is uncommon enough, and the choice between POEM, Heller myotomy, and other options significant enough, that a second opinion, ideally including your manometry results, is a reasonable step.
Book a second-opinion consultation →Both POEM and laparoscopic Heller myotomy are established treatments; POEM has no external incision.
Provides durable relief for most patients, though long-term follow-up is recommended.
Symptom recurrence is possible, though POEM provides durable relief for most. Regular follow-up helps catch recurrence early.
Generally less pain and shorter hospital stay than surgical alternatives.
Some patients develop reflux after POEM, since the procedure affects the same muscle that prevents it, but this is generally manageable with medication if it occurs and is discussed as part of pre-procedure counselling.
Cost varies by hospital stay and case factors. Coverage depends on your specific insurance policy — confirm with your insurer.
Long-standing difficulty swallowing shouldn't be lived with indefinitely.
