Abstract

Achalasia cardia is a esophageal motility disorder characterised by loss of peristalsis in distal esophagus
and failure of lower esophageal sphincter relaxation with swallowing. Available options of treatment are
botulinum toxin injection in to lower esophageal sphincter (LES), pneumatic dilatation of the LES, surgical
myotomy. Per oral endoscopic myotomy (POEM) is a natural orifice transluminal endoscopic surgery
(NOTES) procedure which gained popularity in recent years. Achalasia and other esophageal motility
disorders are now treated with POEM. The principle of poem is similar to Heller’s myotomy, but here
submucosal tunnel is created from mid esophagus to lower esophageal sphincter and up to 2cm distal to
LES (fundus) and myotomy done 2cm proximal and distal to LES. Short term success rate is comparable to
Heller’s myotomy.

Key words: Achalasia cardia,POEM,Endoscopic treatment .