Patient's life saved with POEM
Patient Maggie Palmer has described how an innovative endoscopic procedure performed at University Hospitals of North Midlands NHS Trust (UHNM) has saved her life. Surviving only on Cuppa soups and liquids, Maggie lost almost 16 kilogrammes in weight before being diagnosed with ‘corkscrew oesophagus’, a variant of the condition Achalasia. Maggie underwent the corrective procedure ‘Peroral Endoscopic Myotomy’ (POEM) and is now able to eat proper meals again.
UHNM is the first centre in the West Midlands to perform POEM and the Trust receives referrals from as far away as Wales.
Achalasia is a rare disorder of the food pipe (oesophagus), which can make it difficult to swallow food and drink. In Achalasia, the lower end of the food pipe does not relax and there are no co-ordinated movements in the rest of the food pipe. Most people with the condition find it difficult to swallow food or drink and swallowing tends to get gradually more difficult or painful, to the point where it is sometimes becomes impossible.
Maggie, of Middleton Green, Staffordshire, underwent the POEM procedure in August 2020 at County Hospital, Stafford.
Before undergoing the procedure the 72-year-old retired college worker was unable to eat any solid food.
Maggie said: “I had been completely well before developing the problem, it sort of crept up on me. I wasn’t totally aware of what was going on, but I couldn’t swallow very well and it got to the point where I couldn’t have any solid food at all.
“The POEM procedure saved my life. I wouldn’t say things are perfect now but they are certainly much better. I can eat much more normally and my weight has gone up again. I have to be careful with what I eat now and can’t have big portions, but generally it is much better. I find that puddings go down well, especially with custard!
“I would recommend for anyone to have this procedure, don’t be frightened. A few days before going into hospital you can’t eat anything and for two or three weeks after you are on liquids, but then you can eat more normally. I just have smaller meal sizes. It has massively improved my quality of life.”
Maggie lives at home with partner Barry and enjoys walking her cockapoo Milo, meeting friends for coffee and going out for meals with family.
Over 90% of patients who undergo POEM experience successful treatment which has been shown to be effective for more than 10 years. Because it is a minimally invasive surgical technique patients recover more quickly, with most people being discharged the next day.
UHNM’s specialist endoscopy team performed their first POEM at County Hospital theatres under general anaesthesia. The procedure was carried out entirely through endoscopy, meaning the patient did not require stitches or sustain any skin wounds.
Dr Sarveson Rajkumar, consultant gastroenterologist at UHNM
Dr Sarveson Rajkumar, consultant gastroenterologist and endoscopist at UHNM, said: “I am really pleased to be able to start this service at County Hospital and to offer this effective new treatment. POEM is a minimally invasive alternate treatment to surgery for all types of Achalasia. It is the treatment of choice for Type III Achalasia (corkscrew oesophagus), previous failed surgical treatment for Achalasia and conditions where the foodpipe goes into spasm, for example Jackhammer Oesophagus and Diffuse Oesophageal Spasm.
“We started POEM in March 2020 as the tenth centre in the UK to perform this innovative endoscopic procedure and I have done 14 procedures so far with excellent patient feedback.
“Working in endoscopy at UHNM has been an amazing experience and we have been able to develop and perform some of the most highly specialised procedures and techniques in the country. It’s great for local patients as they have access to super-specialised services delivered by their local Trust. We are now also receiving referrals from outside our local population who are choosing to travel to us for the specialised endoscopy work we provide.”
Tracy Bullock, chief executive of UHNM, said: “I am in awe and very grateful for the lengths the team have gone to, to deliver such a fantastic service to our patients and put our endoscopy unit and UHNM on the map. We really appreciate the work of the team at County Hospital for supporting Dr Rajkumar to make this happen. This is a fantastic achievement.”