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Which Achalasia Treatment Causes Less Acid Reflux? A Look at Two Methods

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Comparison of the safety, efficacy, and rates of gastroesophageal reflux disease between full-thickness versus modified peroral endoscopic myotomy DOI 10.1016j.gie.2025.07.0

Achalasia makes it hard to swallow. This happens when the muscles in the food pipe (esophagus) don’t work properly. Doctors often treat this using a special procedure called POEM (peroral endoscopic myotomy). It helps relax the tight muscles at the bottom of the esophagus.

There are two main ways to do POEM. One is called full-thickness (FT) POEM, and the other is a modified version (MM POEM), which includes newer techniques like OS (oblique fiber-sparing) and CM (circular myotomy).

Researchers looked at nine studies to see which method works better and causes fewer problems. Over 1,200 patients were part of these studies.

Both treatments helped most patients feel better. They had similar success in reducing achalasia symptoms. But there was one key difference. Patients who had the full-thickness POEM were more likely to get acid reflux after the procedure. Acid reflux is when stomach acid flows back into the food pipe, causing heartburn or discomfort.

One of the modified methods (called OS) showed lower chances of reflux. The full-thickness method was quicker to perform, but both had similar safety and results overall.

If you’re thinking about POEM for achalasia, talk to your doctor about which method is right for you. It’s good to know that some types may lower the chance of having reflux after surgery.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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