POEM is completely revolutionizing the treatment of swallowing disorders today, particularly for elderly people who might not be the best candidates for conventional surgical procedures. The particular difficulties older persons with swallowing issues have are addressed by this minimally invasive method, which provides a safer and more effective option. Let’s get into the details below.
Understanding POEM and its relevance to the elderly
POEM is an endoscopic procedure used to access and sever the inner circular muscle fibres of the lower oesophageal sphincter, by making a submucosal tunnel in the oesophagus. This method improves the flow of food and liquids into the stomach by reducing the functional obstruction that characterizes achalasia. POEM eliminates external incisions and reduces recovery time as it is done totally through the mouth, unlike standard procedures. POEM’s less intrusive nature is especially beneficial for older patients, who frequently exhibit comorbidities and diminished physiological reserves. The procedure’s shortened recovery time and reduced surgical trauma makes it an ideal choice for the elderly.
Safety and efficacy in the elderly
POEM has been shown in numerous studies to be both safe and beneficial for the elderly. According to a study, individuals 65 and older had a 95% treatment success rate with minimal side effects. POEM has the potential to be a preferred therapy technique, as evidenced by another study’s conclusion that it is safe and beneficial for elderly patients. POEM’s effectiveness in managing achalasia and related problems was confirmed by a third research that focused on individuals 75 years of age and older. These results highlight POEM’s usefulness as a practical and better choice for senior citizens with oesophageal motility abnormalities.
Comparative advantages over traditional treatments
Although they have proven successful, traditional treatments for achalasia, including pneumatic dilatation and laparoscopic Heller myotomy, have drawbacks, particularly for elderly patients. Despite its effectiveness, laparoscopic Heller Myotomy requires abdominal incisions and a prolonged recovery period, which could be dangerous for older individuals with coexisting medical issues. Whereas pneumatic dilatation uses a balloon to extend the LES, providing momentary relief but frequently necessitating repeated treatments. Another cause of concern is the possibility of oesophageal perforation, especially in elderly people. In contrast to these traditional approaches, POEM offers:
- Minimally Invasive Approach: Reducing surgical trauma, the minimally invasive approach is carried out endoscopically through the mouth.
- Reduced Hospital Stay: Lots of patients leave the hospital one to three days after the procedure.
- Reduced Complication Rates: Even in patients with several comorbidities, research has revealed few adverse effects.
- Long-lasting Symptom Relief: A high percentage of patients experience a continuous improvement in their ability to swallow.
Considerations and precautions
Even though POEM is usually safe, there are a few things to keep in mind when caring for older patients:
- Risks of anaesthesia: As with any treatment that involves general anaesthesia, risk mitigation requires comprehensive preoperative evaluation.
- Postoperative Delirium: Monitoring and preventive measures should be implemented since elderly patients may be vulnerable to delirium following surgery.
- Gastroesophageal Reflux Disease (GERD): Proton pump inhibitors and lifestyle changes may be part of postoperative care for gastroesophageal reflux disease (GERD), as POEM may raise the risk of GERD.
POEM has many advantages over conventional surgical techniques, and is a safe and efficient treatment for achalasia in the elderly. It is a great choice for older persons looking for treatment for oesophageal motility issues because of its minimally invasive nature, high success rates, and positive safety profile. To guarantee the best results, personalized treatment and individual evaluation are crucial, just like with any medical operation. If you are a patient in Ahmedabad, Mission Gastro Hospital is where you can receive expert care for achalasia through advanced POEM procedures. The hospital’s experienced gastroenterology team ensures personalized POEM treatment in Ahmedabad, with a strong focus on safety and recovery.
