10 Signs You May Need Peroral Endoscopic Myotomy (POEM) for Achalasia or Esophageal Motility Disorders

Swallowing feels simple when everything in the digestive tract moves with a steady rhythm. When that rhythm slows, stops, or becomes unpredictable, daily life changes fast. Many people overlook early patterns because the signs feel small at first. Small patterns grow when the esophagus loses coordination. Peroral Endoscopic Myotomy POEM offers a way to address that loss of movement with a minimally invasive approach guided through an endoscope.

Here are signs that deserve attention and a closer look with a specialist.

1. Food Gets Stuck Often

Many people describe a feeling that food pauses halfway down the chest. That pause creates discomfort during meals. This pattern grows when the esophageal muscles tighten too much. A test like high-resolution manometry checks that movement. Specialists then decide if POEM creates better motion in the affected region.

2. Frequent Coughing During Meals

A cough during meals points to disrupted movement in the swallowing pathway. When food lingers, irritation follows. That irritation triggers repeated coughing. An upper endoscopy helps a specialist evaluate lining changes around the narrowed section. If tight muscle fibers create the block, POEM may offer relief.

3. Unplanned Weight Changes

Eating becomes difficult when swallowing slows. People may eat less because each bite takes longer. That change leads to a drop in weight over time. A gastroenterology visit helps uncover the cause. Manometry and imaging often guide the next steps. If the pressure in the lower esophagus stays high, POEM may help restore a smoother passage.

4. Chest Pressure After Meals

Chest pressure during meals feels alarming. Many people confuse it with heart issues. When this sensation connects with swallowing, the esophagus often plays a role. Tight muscle layers limit movement and create pressure. A specialist uses diagnostic tools to study how the lower esophageal sphincter behaves. If the sphincter stays closed too long, POEM may help open that passage.

5. Nighttime Regurgitation

Lying flat increases the chance that undigested food moves upward. That movement often surprises people who experience it for the first time. It signals poor clearance in the esophagus. Capsule evaluations rule out other concerns deeper in the digestive tract. When the main blockage sits at the lower esophagus, POEM may provide a path toward relief.

6. Persistent Hiccups

Hiccups develop when the diaphragm reacts to irritation. Slow movement in the esophagus can create irritation along its length. That irritation triggers hiccups that appear without warning and last longer than expected. A specialist checks for motility disorders through targeted tests. POEM becomes an option when muscle tightness creates the disruption.

7. Long Meal Times

Meals that stretch far longer than before point to swallowing problems. People often adapt without noticing the shift. They chew longer, eat smaller bites, and drink large sips of water to push food down. This pattern reveals a loss of movement in the esophagus. When testing shows a narrow outlet at the lower end, POEM may help restore normal timing.

8. Sudden Throat Clearing

Throat clearing during or after meals signals irritation from lingering food or backed-up fluid. Repeated clearing suggests reduced coordination in the esophageal muscles. Specialists may use endoscopic procedures to explore the lining and movement in real time. If tight muscle fibers disrupt that movement, POEM may offer improvement.

9. Breathing Changes While Eating

Short breaths during meals indicate stress on the swallowing process. When food stays in the esophagus longer than expected, the body responds with protective adjustments. These adjustments include shallow breathing. A detailed evaluation reveals where that delay occurs. POEM supports smoother movement when muscle tension creates a slowdown.

10. Difficulty Drinking Cold Liquids

Cold liquids create spasms in sensitive esophageal muscles. People feel sharp discomfort or sudden tightening during sips of cold drinks. This reaction hints at disordered muscle patterns. Specialists observe those patterns during motility testing. POEM may become part of the treatment plan when cold sensitivity links with obstructed movement near the lower esophagus.

California Digestive Disease Center offers guidance for people who want clarity and steady support with swallowing concerns. Get in touch to take a step toward better digestive health and regain comfort in your daily routine.