Eight-year-old undergoes endoscopic treatment for rare swallowing disorder

An eight-year-old boy diagnosed with Type II achalasia – a rare disorder that affects the ability to swallow food and liquids – has undergone a Perora-l Endoscopic Myotomy (POEM) procedure at Rela Hospital. Achalasia affects the nerves controlling the muscles of the oesophagus, causing the lower oesophageal sphincter – a muscular valve connecting the food pipe to the stomach – to remain abnormally tight.

This prevents food and liquids from passing normally into the stomach. The condition is estimated to affect 0.1 to 0.18 children per 100,000 annually. The child had progressively worsening difficulty swallowing both solids and liquids.

Following the procedure, he was able to resume consuming clear liquids and subsequently, a soft diet, within 24 hours. POEM involves passing an endoscope through the mouth and creating a small tunnel within the oesophageal wall to reach and divide the muscle fibres causing the obstruction.

Unlike conventional surgery, the procedure does not require external incisions or stitches. S.N.K. Chenduran, senior consultant and endoscopic surgeon, Department of Medical Gastroenterology, performed the procedure, which took about 50 minutes.

He said performing POEM in children required particular precision because of the smaller dimensions of the oesophagus and the delicate tissues. Dinesh Jothimani, director, Hepatology and Medical Gastroenterology, said persistent swallowing difficulties, regurgitation, vomiting, and unexplained weight loss in children warranted medical evaluation.