Description
Per-oral endoscopic myotomy (POEM) is an endoscopic procedure used to treat swallowing disorders, most commonly achalasia. POEM is a procedure that uses endoscopic technology to guide an endoscope through the esophagus, creating a submucosal tunnel in the lower part of the esophagus to reach the inner circular muscle bundles of the lower esophageal sphincter (LES) to perform myotomy.
This procedure is intended to reduce the total number of incisions needed and thus the overall invasiveness of surgery.
Gastric per-oral endoscopic myotomy (G-POEM) is a similar procedure with the exception that it myotomizes the pylorus rather than LES.
Medically refractory gastroparesis has been defined as 'persistent symptoms in the context of objectively confirmed gastric emptying delay, despite the use of dietary adjustment and metoclopramide as a first-line therapeutic agent.
The Gastroparesis Cardinal Symptom Index (GCSI) is used to assess the severity of gastroparesis and uses a scale ranging from 0 (none) to 5 (very severe), with a 2-week recall period to rate the severity of nine (9) important symptoms and signs. The GCSI is divided into the following three (3) subscales: nausea and vomiting (three (3) items), postprandial fullness and early satiety (four (4) items), and bloating (two (2) items).
