Achalasia (cardiospasm) is a rare condition that happens when food and liquid doesn’t move through your esophagus to your stomach. Achalasia symptoms include trouble swallowing, heartburn and chest pain. It may cause complications like aspiration pneumonia. Treatment includes surgery and non-surgical options like medication and Botox injections.
At Brown University Health, we offer the full spectrum of modern achalasia treatments, so you don’t need to travel out of state. Our team was the first in Rhode Island to perform Peroral Endoscopic Myotomy (POEM), and we have fellowship-trained surgeons in minimally invasive esophageal surgery who specialize in both endoscopic and robotic approaches.
For patients with achalasia, eating shouldn’t be painful. Marcoandrea Giorgi, MD, leads Rhode Island’s first incision-free peroral endoscopic myotomy procedure (POEM) at Brown University Health, offering lasting relief and faster recovery.
POEM is a minimally invasive endoscopic procedure performed entirely through the mouth. The tight muscle of the lower esophagus (LES) is cut from the inside, relieving obstruction.
POEM requires so external incisions. Patients usually have shorter hospital stays and can return to their normal diet and work sooner. There are excellent short- and mid-term swallowing outcomes.
Patients may have a higher risk of reflux however, your care team will monitor and managed this with you.
Laparoscopic (Robotic Heller Myotomy with Fundoplication) is a small-incision surgery where the lower esophagus (LES muscle) is divided and a partial fundoplication is performed to reduce reflux. Fundoplication is a surgery that helps prevent acid reflux by wrapping the top part of the stomach around the lower esophagus to strengthen the valve between them.
Laparoscopic or robotic Heller myotomy with fundoplication offers long-lasting relief from swallowing problems and helps prevent acid reflux. It’s a minimally invasive procedure with a strong track record, though recovery may take a bit longer than other options and it does require general anesthesia.
Pneumoatic dilation is a non-surgical procedure that involves endoscopic stretching of the lower esophageal sphincter, useful for select patients or those who cannot undergo definitive treatment.
Botulinum toxin injections involve injecting botulinum toxin into the lower esophageal sphincter to relax the muscle and relieve difficulty swallowing. Injections offer temporary relief and are usually reserved for high-risk surgical patients or as a bridge to more definitive therapy.
With a laparoscopic or robotic Heller myotomy with fundoplication, you can expect:
We offer expert, personalized laparoscopic or robotic heller myotomy with fundoplication care backed by advanced techniques and a commitment to long-term outcomes.
