Per-Oral Endoscopic Myotomy-Induced Gastroesophageal Reflux Disease and Review of the Efficacy of Proton Pump Inhibitors as a Management Strategy: Review of the Literature

Talwinder K Nagi; Zoilo K Suarez; Muhammad Adnan Haider; Shaniah S Holder; Charles Vallejo; Sandipkumar S Chaudhari

doi:10.7759/cureus.50324

Per-Oral Endoscopic Myotomy-Induced Gastroesophageal Reflux Disease and Review of the Efficacy of Proton Pump Inhibitors as a Management Strategy: Review of the Literature

Cureus. 2023 Dec 11;15(12):e50324. doi: 10.7759/cureus.50324. eCollection 2023 Dec.

Authors

Talwinder K Nagi¹, Zoilo K Suarez¹, Muhammad Adnan Haider¹, Shaniah S Holder², Charles Vallejo¹, Sandipkumar S Chaudhari^{3

4}

Affiliations

¹ Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
² Medicine, American University of Barbados School of Medicine, Bridgetown, BRB.
³ Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, USA.
⁴ Family Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA.

Abstract

Per-oral endoscopic myotomy (POEM) is a minimally invasive procedure that is very effective in the treatment of achalasia, a rare esophageal motility disorder. POEM has become the first-line treatment for achalasia, with high success rates reported in the literature. However, a known complication of POEM is gastroesophageal reflux disease (GERD). The exact cause and risk factors of post-POEM GERD are not fully understood; however, a number of factors have played a role in its development. The management of post-POEM GERD is mainly by conservative measures, such as lifestyle changes and medications, like proton pump inhibitors (PPI), which are often the first-line method of treatment. However, surgical procedures, such as fundoplication, may be necessary in some patients. This literature review will discuss the effectiveness of the use of PPIs as a management strategy for post-POEM GERD, the factors that lead to PPI-resistant GERD, and other management strategies utilized in these cases.

Keywords: esophageal motility disorders; gastroesophageal reflux disease (gerd); laparoscopic heller myotomy; per-oral endoscopic myotomy; transoral incisionless fundoplication.

Publication types

Review