POEM: Pre-procedural work-up and indications

Joseph Rayfield Triggs, John E. Pandolfino*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter


Peroral endoscopic myotomy (POEM) is a transluminal endoscopic procedure which dissects the lower esophageal sphincter via access obtained through a submucosal tunnel. The procedure was first developed as a treatment for achalasia, but its indications have quickly spread. In addition to all the clinical subtypes of achalasia, its indications now include a subset of patients with esophagogastric junction outflow obstruction, distal esophageal spasm, jackhammer esophagus, and as retreatment following prior achalasia therapy. Current clinical practice suggests that the minimum work-up required prior to POEM should include upper endoscopy and high-resolution manometry. Here we review the growing body of literature regarding indications for POEM and the appropriate work-up including advanced diagnostic testing to identify those patients who are most likely to benefit from LES targeted therapy.

Original languageEnglish (US)
Title of host publicationGastrointestinal Interventional Endoscopy
Subtitle of host publicationAdvanced Techniques
PublisherSpringer International Publishing
Number of pages16
ISBN (Electronic)9783030216955
ISBN (Print)9783030216948
StatePublished - Jan 1 2019


  • Achalasia
  • DES
  • HRM
  • Jackhammer
  • POEM High-resolution manometry

ASJC Scopus subject areas

  • General Medicine


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