Peroral Endoscopic Myotomy (POEM) | Q&A
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- Опубліковано 29 кві 2013
- Mouen Khashab, MD, Assistant Professor of Medicine and Director of Therapeutic Endoscopy, Johns Hopkins Gastroenterology & Hepatology, discusses Peroral Endoscopic Myotomy (POEM) - how it is performed, who is eligible for the procedure, expected outcomes and the key benefits.
For more information, visit the Division of Gastroenterology & Hepatology webpage at www.hopkinsmedicine.org/gastro...
Or call 443-287-1960.
Questions answered:
1. What is POEM? (0:11)
2. What is Esophageal Achalasia? (0:30)
3. Who does this condition effect and what symptoms are common? (1:20)
4. How is POEM performed? (1:46)
5. Who is eligible for the procedure? (3:12)
6. What are the expected outcomes? (3:36)
7. What are the key benefits of POEM? (3:54) - Наука та технологія
I am 13 years, from the Netherlands and I have Achalasia to😔It’s very interesting to watch this video. The most time people don’t even know what I talk about if I try to explain what it is. It’s hard to life with Achalasia so i am very happy with the POEM☺️ Sorry for my English it’s very bad.
if I get surgery again soon it will be this one. I always find it exciting so I am super happy with this explanation.
⚠️⚠️⚠️Let's get an update. I'm 15 now and luckily I haven't had another surgery. Eating is still good, so I'm super happy with that. I do suffer from cramps and I do have this pretty much every day. This really hurts a lot. Maybe someone with the same experience has tips for these painful cramps? But for now I'm healthy!
I hope you are doing well and otherwise a lot of strength! Stay healthy!
Did you get your surgery
u ok?
I have achalasia too
Spasms are the worst! I’ve had Achalasia since 2009 no surgery yet. Waiting for approval for the POEM. Apples and fresh juice made daily have always helped with the heavy spasms.
COME TO INDIA BROTHER..INDIA OFFERS GOOD TREATMENT IN THIS
how well does this work for diffuse esophageal spasms, and how long will this procedure last once performed.
Hi. This is the only discussion board that I have been able to find on achalasia and the POEM procedure. Does anyone here know of other blogs for this condition? I would like to join one. I am 75 and live in Australia. I am going to have a POEM in the next few months.
Isn't poem have higher mediastinitis, perforation rate than heller myotomy ?
GOOD TO KNOW ABOUT POEM
I’m having this procedure done in a week from today. I have stage 3 Achalasia with a corkscrew esophagus. Anyone else have the same diagnosis - I’m a bit nervous.
Just had my procedure the other day. I'm supposed to be on a liquid/fluid diet for another week. Water and soda is going down fine but I tried to eat some yoghurt and mouse and it's getting stuck like it used to. I'm gonna be strict and stick to liquid for a few more days until my throat has properly healed.
Hello Walwin, my wife is having Achalasia too. We are thinking of going with POEM surgery. Kindly share your update regarding swallowing solids and liquid.
Thank you.
Hey. How are things?
How are things?
My nane is Petrina, I am from Brazil. I have Achalasia II. I have felt strong pain. My back seems is will have a big hole. I dont know how to explain. The pain "cut" from my breast until my back.
My question is about how long POEM can make me feel better. Are there cientific evidences about how effective POEM is?
Can Achalasia getting worst after POEM?
Hi Petrina, , thank you for reaching out to us. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.If you would like to request an appointment at one of our hospitals, please call +1-410-502-7683. Our medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins Medicine International also provides language interpretation, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.
My wife is having this procedure. Thanks for breaking it down.
Michael Tkach how’s your wife
@@ericamartin6478 the surgery went well. A lot of belching and is on soft food till the end of the week. Thanks for asking.
You’re welcome .I’m going to have the same procedure so I’m nervous in seven days thank you for replying.
@@ericamartin6478 good luck with your procedure. Follow all instructions before, during and after. Very important. You will do fine. My wife was tired for a few days afterwards. The Dr said thst is normal.
Michael Tkach I will follow all instructions also thank you very much 😊
I have also achalasia, and for me it is stress related. I dont know why, but after taking vitamine C it reduces my cramps. Someone told me it was an auto imuun disease so vit C was worth trying. So that helped me alot. Now i have cramps ones a week sometimes ones in two weeks, but with stress, i get them the same day.
When i get my cramp, its unbarable, it hurts and feels like its not going away, i start sweating and turn white. What gives me IMMEDIATE RELIEVE is eating a banana. Why a banana? Because with so much pain i dont have time to chew. Something that is thick inough to passage and but doesnt need much chewing. I eat the whole banana and that pushes my muscles by fors to relieve. It doest enter my stomach directly, but gives me immediate relieve. Than with a full glass of water i push it down. REALLY PUSH IT DOWN with fors. I hope this method will help someone.
alternatives to surgery ?
I had the POEM procedure performed in July, 2013 by Dr. Rivas at Stanford. I was laid up for a few days but rebounded pretty quickly. Once normal foods were allowed, I noticed a huge improvement. For context, if my swallowing was at 20% of normal, the procedure increased it to 80%. Unfortunately, these results lasted only briefly and I noticed the symptoms coming back in October, 2013. Currently, I estimate my swallowing capacity at approximately 30% of normal and I am returning to Stanford to address what appear to be motility issues higher in the esophagus. I am unable to determine whether the returned symptoms are the result of the POEM procedure losing its effectiveness or whether they are the result of other Achalasia symptoms.
How are you feeling now since? My wife is going to have the poem surgery this year.
So what did you do since its been three years, these Drs are full of shit they talk and sure like if they are trusted, you should've done the HM is for life long lasting, and it is way better, it is the actual deal VS poem people experience bad results from it and they have redo it again.
Andreas cool Did you get the surgery
Doctor please, I need your help. I'm from Venezuela, so obviously they can't serve me in the United States, there are no resources for that. So I just want to know if this procedure can be performed on people who have a dilated esophagus, megaesophagus. I hope you answer me, please. I am suffering and have advanced achalasia.
Hi, thank you for reaching out to us. We’re very sorry to hear about what you’re going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.
If you would like to request an appointment at one of our hospitals, please call 888-872-1408.
@@JohnsHopkinsMedicine Thank you!
at 4.07 he was talking about Heller myotomy
I'm having this done tomorrow. I haven't eaten in a week. Just get this surgery done so I ca recover and shovel food into my mouth
Hello how are you doing now
Did it work?
Hey any update? I’m really curious if it worked?
@@bkr1203 Yes, surgery was an absolute success. As long as I eat with relatively small bites, and chew the food properly going down has no issues for the most part.
Sometimes food does still get stuck, but all it takes is a sip of a drink and I'm good to go.
When I went into the hospital, I was 103 pounds, 10 days away from total organ failure. Almost 2 years later, I'm back to a normal, healthy weight, and back to my old life. 😁
@@cody12345249 hey that’s great news. I’m getting a poem in early June. I’m very nervous. I really want to get back to eating normal again.. or at least normal enough where I don’t get anxiety before every meal lol
Dear sir, when the endoscopic clip are removed? My sugary done by Indian dr. Amol bapay at 19 jan 2019
Hi.. where did you perform this surgery ? Could you please share the contact info. Even I am diagnosed with achalasia. I am seeing this doctor in video and he suggested the procedure POEM + TIF (transoral fundoplication).. But my insurance may not cover it so I am thinking of getting it done in India. Did you get TIF done as well? How is your exp of POEM and the doctor?
@Akshay Shende Bhau, mi pn punyacha aahe, mazya bhawala pn achalasia zalay, dr. Bapay kde janyacha vichar aahe, tuzi operation baddal information pahije hoti, pls contact no share Kru shakto ka?
@AFisLive thanks
@AFisLive why ,,,its so haunting
@AFisLive is he still available, and what is the cost there for POEM
There seems to be a big debate between the LHM and wrap and POEM due to reflux. What are the percentages for the reflux for each?
Elka, I know your comment was 10 months ago, but here is what I found because I was interested in this percentage, as well: www.ncbi.nlm.nih.gov/pubmed/28549006
achalasia cannot be cured 100% with surgeries, patients 'may' have to go through swallowing issues and gerd/IBS/gastroparesis and in some patients it gets so worse that they get GI or nasal tube for feeding, and there is a entirely different surgery when esphageus loses it peristalsis which is called esophagectomy and there are other treatments as well, achalasia is not stable in everyone it progresses and rises other health issues.
Haw cost please ?
At 4:22 he says "At least two years durable" What does this mean? The comment is very vague. Does it mean the effect of the procedure lasts only two years? Then you need it again? The lasting effect of the procedure is very poorly explained in this video.
Bob Palmer I am on track for having this surgery this summer. What I found out is that this surgery is so new to the medical field that they don't have the long term data to say exactly how long this surgery will last for patients. At Hopkins two years is how long its been since their first patients have had this surgery.
Michelle Simmons - Did you end up having this surgery with Dr. Khashab. I have an initial consult with him in September. Curious about your experience and outcome.
I have not had the surgery yet because my insurance denied it. They claim it's experimental. Johns Hopkins is in the process of appealing on my behalf. But I have had a couple of other smaller procedures with him and he is great! I would recommend him to anyone with no hesitation.
How is it now going with you Bob and everyone in this message?
Hi everyone - my mom is looking into this surgery, wondering how everyone is doing? Wishing you all the best.
At least 2 years durable? And then what? Normal swallowing? With a loss of peristalsis? Have you attempted to swallow without peristalsis? I have. It is NOT normal.
I had this surgery 2 and a half years ago, it didn’t really changed anything. I went to see the doctor again and he said we can do the POEM surgery and but cut the opposite muscle. I didn’t do it. 2 and a half year later I’ve experiencing extreme pain a that level, usually at midnight, and that’s the reason I’m typing right now. I no longer know what to do cause going to all the procedure again, with all the after pain, hospital week, the cost of it ....
POEM surgery again but*
Hi Ascelin, thanks for reaching out to us. We’re very sorry to hear about what you’re going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.
If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, financial counseling, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.
@@JohnsHopkinsMedicine hi i am from india my wife having same issue will u help me sir, +919879175628 jayesh taylor
Every two years? Oh no! Its already to thin. And a few had this done to know affect. Doctor want to do other side. They said no way.. To risky for them. Is this a high herna sugery ?
poem surgery cost
i am lively 34 years inborn have achalasia
Can a patient who did POEM do stomach training to gain 6 packs?
bruh
In symptoms of achalasia
There isn't heartburn because gastric content doesn't reflux into oesophagus..
you are right but , heartburn doesn't arise from acid in achalasia . it can be from other things تحياتي اخي
I have familial Achalasia and yes there IS angina in the pipe itself from mast cell activation-degranulation.
Depois a pessoa volta ter vida normal?
Jussara Soares Normal creio que não, pois não a cura apenas controle, mas trás uma ótima melhoria no refluxo, e disfágia segundo as pesquisas e consultas q fiz.
At least two years durable" this sentence also stuck me. Can you please explain ?
Diwakar Sinha means after 2 years you need to do it again
Pointless then. Unless you dont have any other options
@@faisalk379 why again i cant spend this much money every 2 yrs
@@TheTEAR1 how much ?
@@bridneyandino713 2 lakhs indian rupees
it is such a hell to live with achalasia
I had the Heller Myotomy 8 years ago because of severe conditions. 2 years ago, the symptoms slowly returned. It got very bad again and I had the POEM procedure this past Monday. I am having significant relief now, although there is residual pain. i will have liquids only for 1 week, then pureed foods for 1 week. Then I can graduate to soft foods on week three. My hope is that I am at least 90 percent cured. If you get reflux, my best go-to is plain or vanilla greek yogurt. It can give almost immediate relief. Hopefully, I won't have to take a protein pump for too many months. Good luck with your treatment.
@@mikebrock7606 Hello Mike. My wife is having Achalasia too. We are thinking of going with POEM surgery. Kindly share your update regarding swallowing solids and liquid after POEM.
Thank you in advance.
@@theresponder01 The surgery went very well and I can swallow much better. Not 100% better but it is excellent improvement. I will have to still modify eating and take meds to control reflux. I recommend the surgery over the Heller Myotomy. I had the Heller Myotomy 8 years ago and it failed. PEOM Seems much better alternative.
@@mikebrock7606 Thank you so much for replying Mike. I hope you get back to normal very soon.
If I may ask, did the doctor mention anything regarding for how long the POEM procedure would be effective? Also, did they suggest any further procedure to control the reflux?
Take care.
@@theresponder01 This procedure has only been around since 2012 and began in Japan. So, there are no real long term statistics on the PEOM. All I know is that my heller myotomy lasted 8 years. So, I am one of the few who has had two surgeries for this issue. I do know that statistics are looking good for the POEM at this point. Feel free to do your research and ask your doctor. I am hopeful for your procedure and recovery. I will say POEM recovery is much easier than the heller myotomy. Take care and let me know how you are doing.
This dr says its good for two years and thinking that it can go longer, bowl shit. Two years and not sure if it can go any longer then do botox it is the same deal with out any surgery, in fact skip poem and go for the original surgery of HM this is the one that needs to be done for Achalasia patients and its a life long lasting surgery
Andreas cool no the only reason they say that is because it’s a brand new procedure so they haven’t got data on long term outcome and are not allowed to say it will last longer without waiting for evidence. They reckon it is to work as well as hellars myotome so basically is a lifetime solution but seeing as they only have like 5 years of data so far they can’t make such guarantees that’s all. Much better solution than Botox
If this has to be done every 2 years or so, why wouldn't I go for the Botox instead? That supposedly last a year or so, and is just injections as opposed to actual surgery. I'd rather have shots every year than surgery every 2 years. Still discussing with my doc.
normally Poem procedure last for all your live, and its necessary perform only one time
Botox actually last about 5 months and eventually stops working