Researchers report a growing awareness of gastroesophageal reflux problems among patients who undergo endoscopic, nonsurgical treatment for esophageal achalasia, frequently requiring future surgical intervention. Peroral endoscopic myotomy (POEM) has been a treatment of choice for the past decade, but patients may develop severe heartburn and regurgitation that does not respond to medical treatment, as described in an article published in Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST).

Kamil Nurczyk, MD, Timothy Farrell, MD, and Marco Patti, MD, from University of North Carolina at Chapel Hill and Medical University of Lublin (Poland) coauthored the article entitled “Antireflux Surgery for Gastroesophageal Reflux Refractory to Medical Treatment after Peroral Endoscopic Myotomy.” The authors express the concern that with POEM, one disease, achalasia (the backup of food within the esophagus) is being replaced with another, gastroesophageal reflux disease (GERD). They describe patients who experienced post-POEM reflux that was refractory to treatment with high doses of proton pump inhibitors and who required laparoscopic partial fundoplication surgery to eliminate their symptoms.

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