Peroral Endoscopic Myotomy (POEM) for the Treatment of Achalasia (POEM)


About this study

Achalasia is a rare disorder of the esophagus characterized by absent peristalsis and impaired relaxation of the lower esophageal sphincter. This results in dysphagia, or the inability to swallow, and can lead to malnutrition and failure to thrive in severe disease. POEM has emerged as an effective, minimally invasive therapy for achalasia, enabling selective circular or full thickness myotomy through the distal esophagus, esophagogastric junction (EGJ) and cardia. POEM is a natural orifice transluminal endoscopic surgery (NOTES) alternative to Heller myotomy, and does not involve incisions to the chest or abdomen. This outpatient procedure involves same-day discharge or an overnight stay in the hospital for observation. As a relatively new procedure, long term outcomes are not well defined. Furthermore, issues regarding patient selection for POEM versus Heller myotomy or pneumatic dilation, predictors of treatment response, and assessment of complications following POEM, including  gastroesophageal reflux disease, need to be defined. 

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Patients ≥ 18 years old
  • Patients undergoing POEM for:
    • Achalasia (types I, II, and III);
    • Non-achalasia esophageal motility disorders (e.g., diffuse esophageal spasm).
  • POEM performed at Mayo Clinic by providers in the Division of Gastroenterology or the Division of Thoracic Surgery.

Exclusion Criteria:

  • Patients < 18 years old.
  • Patients with prior POEM performed outside of Mayo Clinic.
  • Prior upper gastrointestinal surgery.
  • No authorization for research participation at Mayo Clinic.
  • Inability to communicate/provide history of symptoms.

Eligibility last updated 2/17/22. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Karthik Ravi, M.D.

Closed-enrolling by invitation

What is this? (?)
Not open to everyone who meets the eligibility criteria, but only those invited to participate by the study team.

Contact information:

Crystal Lavey CCRP

(507) 538-1361

More information


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