The following is a summary of “Peroral Endoscopic Myotomy Is an Effective Treatment Option for Managing Jackhammer Esophagus: A Single Center Experience,” published in the July 2023 issue of the Clinical Gastroenterology by Canakis et al.

Jackhammer esophagus (JE) is an infrequent hypercontractile motility disorder frequently accompanied by dysphagia, regurgitation, and chest pain. In individuals presenting with clinically significant symptoms, the primary objective of treatment options is to reduce esophageal contractions. Medical, endoscopic, and surgical interventions exhibit restricted long-term effectiveness. The emergence of peroral endoscopic myotomy (POEM) has developed as a minimally invasive therapeutic alternative. However, data are scarce concerning Japanese encephalitis (JE). Therefore, the researcher’s objective was to assess the medical effectiveness of JE. This was a retrospective study conducted at a single medical center involving a series of adult patients who underwent peroral endoscopic myotomy (POEM) for Jackhammer esophagus (JE) between April 2018 and September 2021.

A sole endoscopist performed all procedures. The study’s primary outcome was clinical success, defined as achieving an Eckardt score (ES) of 3 or lower after the process.  About 13 patients (mean age 58, seven females) underwent peroral endoscopic myotomy (POEM) with a mean duration of symptoms of 42.6 months. The preoperative mean ES was 8.92. Around 9 patients presented with no prior medical intervention. The pre-procedure endoluminal functional luminal imaging probe (n=10) revealed a distensibility index of 0.34. The mean duration of postoperative evaluation following peroral endoscopic myotomy (POEM) was 15.8 months. The clinical success rate was 92.3% (12 out of 13 cases), with a mean post-POEM esophageal sphincter (ES) measurement of 1.53. The patient’s esophageal symptoms (ES) showed improvement from a score of 12 to 1 following peroral endoscopic myotomy (POEM) intervention. 

However, approximately 2.5 years later, the patient experienced a recurrence of symptoms, with an ES score of 10. Only one patient exhibited endoscopic findings consistent with Los Angeles grade A esophagitis. One year post-peroral endoscopic myotomy (POEM), five patients presented with symptoms indicative of gastroesophageal reflux disease (GERD), yet only two necessitated acid suppression therapy. POEM (Peroral Endoscopic Myotomy) is a highly effective therapeutic modality with proven long-term efficacy in medical practice. Further, extensive clinical trials are required to substantiate these findings.

Source: journals.lww.com/jcge/Abstract/2023/07000/Peroral_Endoscopic_Myotomy_Is_an_Effective.5.aspx