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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will The Pneumatic Dilatation Not Work If The Esophagus Pressure Is High?

Hi I am also a internal Medicine Specialist.Underwent Pnumatic Dilatation 3 yres Back.Now again I have symtoms.I am 61 yrs of age .did manaometry stuties today .My doctor is in favour Of POEM.
Will nd dailatation work ? the lower end Oesphagous pressure is High .
Pl advice. POEM IS NOT AVAILABLE IN PUNE..
Mon, 27 Feb 2017
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General Surgeon,  's  Response
Hello sir,
1) POEM is available in pune
2) Pneumatic dilatation on any narrowed portion has high recurrence rate as this process does not do any structural change in abnormal part. Due to elasticity of esophagus from its muscular layer, it regain previous natural caliber and so overtime you might develop symptoms again.
3) POEM offer structural change in esophageal wall which cause slight increase in caliber of esophagus. Also POEM affect propagation of neuronal activity in sero-muscular layer which help to reduce intra-luminal pressure.
4) POEM is standard treatment after multiple attempts of pneumatic dilatation in case of esophageal spasms.
5) This difference is same as anal dilation vs sphincterotomy for chronic anal fissure.

Hope I answered your query. If you have any further doubts, I would be happy to help you.
Have a nice day!
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Will The Pneumatic Dilatation Not Work If The Esophagus Pressure Is High?

Hello sir, 1) POEM is available in pune 2) Pneumatic dilatation on any narrowed portion has high recurrence rate as this process does not do any structural change in abnormal part. Due to elasticity of esophagus from its muscular layer, it regain previous natural caliber and so overtime you might develop symptoms again. 3) POEM offer structural change in esophageal wall which cause slight increase in caliber of esophagus. Also POEM affect propagation of neuronal activity in sero-muscular layer which help to reduce intra-luminal pressure. 4) POEM is standard treatment after multiple attempts of pneumatic dilatation in case of esophageal spasms. 5) This difference is same as anal dilation vs sphincterotomy for chronic anal fissure. Hope I answered your query. If you have any further doubts, I would be happy to help you. Have a nice day!