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Monday, July 26, 2021

Difficulty Swallowing

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Innovative, minimally invasive procedure now available for patients with swallowing disorders and frequent nausea/vomiting

Swallowing disorders can take away the simple joy of eating and drinking. For the many people across the country suffering from swallowing disorders such as achalasia, eating and drinking can become a miserable experience and dramatically impact their quality of life.

New hope has arrived for patients in North Louisiana, thanks to the expertise of Qiang Cai, MD, Ph.D. Dr. Cai is one of the first in this country to begin performing an innovative, minimally invasive procedure pioneered in Japan and China to treat swallowing disorders. He is one of the most advanced endoscopists and recently joined Ochsner LSU Health Shreveport.

The technique is called Peroral Endoscopic Myotomy (POEM). This procedure utilizes endoscopic technology and surgical myotomy to permanently relax the esophageal muscles causing swallowing difficulties. Performed under general anesthesia, a flexible tube is used to access the lower esophageal sphincter (LES). Small incisions are made to relax the esophageal muscles, allowing food and drink to again flow easily into the stomach.

POEM is primarily used to treat patients who suffer from achalasia, a disorder that prevents the esophageal muscles from fully relaxing. This causes patients to experience swallowing difficulties, regurgitation, chest pain, heartburn and weight loss. Nonsurgical treatments for achalasia can include medication, balloon dilation and Botox injections. However, surgery is the next option if those treatments are unsuccessful. Until the introduction of POEM, the opensurgical procedure required multiple abdominal incisions to access the esophagus and perform the myotomy.

“This procedure (POEM) is unique because we use an endoscope and small knife through the scope to create a tunnel under the esophageal mucosa,” said Dr. Cai. “Then, we cut the circular muscle around the esophagus to release the tightness at the end of the esophagus, while leaving the longitudinal muscle intact. No skin incision is made.”

Patients undergoing the POEM procedure experience a shorter hospital stay or are discharged home on the same day, with a shorter recovery time and less postprocedure discomfort than the traditional open-surgical procedure. Because no abdominal incision is made, there is no risk of injury to other organs, post-surgery infection or scarring.

“We believe this technique is much better for the patient because the procedure is effective, shorter, causes less complications, and patients recover more quickly without skin incisions,” said Dr. Cai.

A similar procedure is also showing promise in patients with gastroparesis.

Gastroparesis is a condition that affects the muscles of the stomach and intestines, causing food to move too slowly through the stomach and results in frequent nausea and vomiting. It occurs in patients with diabetes and other conditions. However, it is also seen in patients with no underlying causes.

To learn more about Dr. Cai and the gastroenterology services offered at Ochsner LSU Health Shreveport, visit ochsnerlsuhs.org.

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