First treatment of achalasia cardia in State

3 October 2013

Kerala

The newly developed endoscopic procedure for treatment of achalasia cardia was performed at a hospital for the first time in Kerala.The procedure called peroral endoscopic myotomy (Poem) was done on a 62-year-old patient by Dr Roy J.Mukkada, senior consultant, Gastro Enterology and associate director of GI Endosocopy at the Lakeshore Hospital at Cochin last week.

Achalasia cardia is an uncommon disorder that causes difficulty in swallowing. The main cause of achalasia is degeneration of the nerve cells in the esophagus. It involves inability of the muscle situated between the lower esophagus and the stomach to open and let food pass into the stomach.

As a result, patients with achalasia have difficulty in swallowing food and feels chest pain during eating. The patient, on whom Poem was performed, was suffering from the diseases for several years and had lost weight considerably, said Dr Roy.

He told that the condition was diagnosed by endoscopy, manometry and Barium X-ray. The patient was fed through mouth on the second day of the procedure itself and could be discharged on the third day.

Poem, which was pioneered by Japan and China recently, is a surgical procedure done through endoscopy with hybrid knife. No scars and less morbidity are its advantages. The procedure involves passing an endoscope into the esophagus and making an incision in the lining (mucosa) of the esophagus.

Dr. Roy, who was trained in this technique from Fudan University, China, said that the procedure had distinctive advantages compared to the established treatments such as endoscopic balloon dilatation and laparoscopic myotomy.While the endoscopic balloon dilation involves a small risk of balloon perforation during the procedure in laparoscopic myotomy the patients need more hospitalisation. None of the treatment revert the nerve problem.

Source – http://www.khaleejtimes.com

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