Per Oral Endoscopic Myotomy (POEM)

When your child has trouble swallowing food or liquids, Nationwide Children's Hospital offers cutting-edge procedures for our patients, including per oral endoscopic myotomy (POEM). This procedure is less invasive than other treatments and helps to treat swallowing disorders caused by muscle spasms in the esophagus.

Muhammad Khan, MD, MPH, FASGE, is a pediatric gastroenterologist and director of interventional and diagnostic endoscopy at Nationwide Children’s. Dr. Khan is one of only a few endoscopists trained and experienced in performing both esophageal and gastric POEM procedures in children.

What Is Per Oral Endoscopic Myotomy (POEM)?

POEM is a minimally invasive procedure that can effectively treat the symptoms of swallowing disorders like achalasia.

Achalasia is a rare swallowing disorder that affects the ability of the esophagus to move food down to the stomach. Symptoms of achalasia can include difficulty swallowing food and even liquids, chest pain and throwing up (regurgitation) of food. These symptoms can be frustrating and even debilitating, making it difficult for patients to eat normally. Significant weight loss often occurs as a result.

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POEM at Nationwide Children’s

POEM is a newer endoscopic procedure that doesn’t require traditional surgery to treat various conditions, such as achalasia, esophageal spastic disorders, gastroparesis and pyloric stenosis. While there are several endoscopists who can perform POEM procedures for adults, very few can safely do this procedure in children.

One pioneer in this area is Muhammad Khan, MD, MPH, FASGE, pediatric gastroenterologist and the director of interventional and diagnostic endoscopy at Nationwide Children’s. Dr. Khan completed extra training in interventional endoscopy that includes the surgical endoscopy skills for POEM, as well as endoscopic ultrasound, pancreaticobiliary endoscopy and complex polyp resections.

Meet Dr. Khan

Is POEM Right for My Child?

Children with swallowing or motility disorders like achalasia may be considered candidates for a POEM procedure. The gastroenterology team will consider your child’s condition, previous testing, and may recommend additional testing to ensure the best care for your child. Before undergoing a POEM procedure at Nationwide Children’s, your child will receive a full medical and surgical evaluation, and various treatment options that are best suited for your child will be reviewed.

What is Achalasia?

How is POEM Done?

The POEM procedure is performed via endoscopy. An endoscope is a long, thin, flexible tube which has a camera on the end. Through the endoscope, various tools are passed to perform diagnostic testing and interventional therapies. During the POEM procedure, the endoscope is passed down the mouth and into the esophagus or stomach. A small cut (incision) is made in the inner lining of the esophagus or stomach, and then the affected muscle layer is exposed. The muscle layer is then cut (called a myotomy), allowing the muscles to relax and food to pass through more easily. The small incision is finally closed with a few tiny clips, and the lining heals.

The POEM procedure:

  • Is less invasive than traditional procedures like a laparoscopic Heller myotomy
  • Requires shorter recovery time (typically, patients only need a single night of monitoring before discharge, versus a week-long stay after a Heller myotomy)
  • Results in fewer complications than traditional surgical procedures (with success rates ranging from 92 – 96% in children)

Learn About the Motility Center

Why Nationwide Children's?

At Nationwide Children's, we are uniquely equipped to handle the care of pediatric patients with swallowing disorders like achalasia. There are not many surgeons who are trained to perform complex endoscopy procedures, like the POEM procedure, in pediatric patients. Muhammad Khan, MD, MPH, FASGE, pediatric gastroenterologist and the director of interventional and diagnostic endoscopy, specializes in performing POEMs.

Dr. Khan received additional training in interventional endoscopy to treat more children using less invasive strategies. His surgical skills include POEM, endoscopic ultrasound, pancreaticobiliary endoscopy and complex polyp resections. He is the only pediatric gastroenterologist in the United States performing all of these interventional endoscopy procedures in pediatric patients.

Our team, combined with our state-of-the-art equipment and facilities, allow us to provide the highest level of care for our patients, ensuring that they receive the best possible outcomes from their procedure. We are committed to working closely with our patients to develop personalized treatment plans that meet their unique needs and help them achieve the best possible results.

If you know of a child that is experiencing swallowing disorders like achalasia, we encourage you to contact us to learn more about the POEM procedure and how it can help. Our team of experts is here to answer your questions and guide you through the process, ensuring that you receive the care and support your child needs to achieve optimal health and wellbeing.