pISSN 2636-0004eISSN 2636-0012
pISSN 2636-0004Facts 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.