pISSN 2636-0004
eISSN 2636-0012

Table. 1.

Facts and Fictions in Development of GERD after POEM

Fiction Fact
GERD after POEM is very common Abnormal acid exposure post-POEM is common, however, warrants redefining AET
GERD is seen in all patients after POEM Seen in only about 50% of patients
All patients need to be treated with antireflux procedure About 50% patients with GERD post-POEM have abnormal acid exposure, but are asymptomatic, hence, don’t need intervention. Only 10% of symptomatic patients might need future intervention
Reflux will kill POEM POEM has established itself, hence, about to stay for a long period of time in spite of reflux
POEM-F is the standard of care Surgical fundoplication also doesn’t stay for a long period of time and there is recurrence of symptoms. POEM-F has problems
High acid exposure time post POEM corresponds to GERD Post-POEM, about 50% of patients with abnormal AET might be attributed to fermentation. Lyon Consensus, patient symptoms and frequency need to considered
POEM results in postoperative reflux and fundoplication is necessary in all Postoperative reflux is asymptomatic in majority of the cases and fundoplication is necessary in symptomatic patients with abnormal 24-hr-pH metry findings

GERD, gastroesophageal reflux disease; POEM, peroral endoscopic myotomy; AET, acid exposure time; POEM-F, POEM with fundoplication.

Int J Gastrointest Interv 2020;9:62~66 https://doi.org/10.18528/ijgii200009
© Int J Gastrointest Interv