Gastroenterology & GI Surgery

Underwood Center's Achalasia Program Employs Leading-Edge Technology, Treatment and Research to Improve Care

Dec. 1, 2023 - Eden McCleskey

Achalasia, a rare swallowing disorder that typically affects adults 30 to 60 years old, causes muscles in the esophagus to not contract properly, resulting in food not being propelled downward toward the stomach. Its cause is unknown, though it may be linked to inflammatory autoimmune disorders, research suggests.

With one of the busiest diagnostic GI laboratories in the country, the Houston Methodist Underwood Center for Digestive Diseases is able to accurately diagnose achalasia as well as a variety of other swallowing problems that share similar symptoms.

While the condition is relatively uncommon, Houston Methodist's experience and expertise treating the disease attracts a large volume of cases annually, making it one of the top three programs in the country.

"Unfortunately, medications for achalasia don't typically work very well, so our efforts are often procedural, with both short-term and long-term solutions," said Dr. Gulchin Ergun, a Houston Methodist gastroenterologist and swallowing disease expert. "We work together with surgeons to handle the full spectrum of cases, with the goal of allowing every patient the ability to eat well and have a good quality of life."

Houston Methodist surgeons also are highly proficient with newer technologies such as the robotic-assisted Heller myotomy with Dor fundoplication and peroral endoscopic myotomy (POEM). In clinical trials, such technologies have been shown to cause fewer postsurgical complications.

The robotic Heller myotomy has a 0% esophageal perforation rate and a median length of stay in the hospital of just one day.

Other new tools like Esoflip™ and Endoflip™ enable surgeons to get real-time feedback on surgical success through monitoring changes in sphincter pressure, ensuring symptom relief while reducing the risk of reflux.

Clinical differentiators:

  • Intraoperative tools enable our specialists to measure motility, distensibility, diameter and cross-sectional area around the gastroesophageal junction to ensure successful outcomes
  • POEM (peroral endoscopic myotomy) is a breakthrough procedure that treats achalasia and other conditions endoscopically

Research initiatives:

  • EndoFlip studies on success of surgical procedures
  • Studies on the optimal surgical approach to gastroesophageal reflux
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