GPOEM (Gastric Per-Oral Endoscopic Myotomy)

G-POEM is typically considered for adults who have refractory gastroparesis, which means their symptoms have not improved enough with standard medical care. You might be a candidate if a properly performed four-hour test has confirmed that your stomach empties too slowly. It is also important that imaging or an upper endoscopy has ruled out any physical blockages. Usually, patients have already tried changing their diet, managing their medications, and optimizing their nutrition before discussing this procedure. Dr. Dunn will review your full medical history, including your symptoms and prior treatment attempts, to see if the pylorus muscle is likely contributing to your health concerns and if this approach is appropriate for your specific situation.

Preparing for your evaluation starts with gathering your medical records. You should bring your gastric emptying study report, upper endoscopy results, and any relevant imaging like a CT scan. It is also helpful to provide a complete list of your current medications and diabetes records if they apply to you. If you move forward with the procedure, your care team will give you specific instructions. These typically include fasting for a certain period and adjusting your usual medications. Because the procedure requires general anesthesia, you must also arrange for a ride home afterward. Following these steps closely helps ensure your medical team has the information they need for a safe and thorough review of your condition.

The G-POEM procedure is an advanced way to treat gastroparesis without making any external cuts on your body. While you are asleep under general anesthesia, the doctor passes a thin, flexible camera called an endoscope through your mouth and into your stomach. The physician makes a small opening in the stomach lining to reach the pylorus, which is the muscle that acts as the stomach's outlet. A precise cut is made in this muscle to help it relax, allowing food to pass more easily into the small intestine. Finally, the internal opening is closed using small clips or sutures. This internal approach is less invasive than traditional surgery, though it still requires specialized medical skills and careful monitoring.

Recovery after G-POEM varies for every patient. Some people stay in the hospital for observation, while others may go home the same day. You may experience temporary throat soreness or abdominal discomfort as you wake from anesthesia. Your care team will help you gradually advance your diet as you heal. While many patients see an improvement in symptoms like nausea and vomiting, results depend on the underlying cause of your condition. It is important to understand the potential risks, which can include infection, ulcers, or bleeding. In rare cases, air may enter the abdomen during the process. Dr. Dunn will discuss these possibilities with you to ensure you have a balanced understanding of what to expect during your recovery.