G-POEM Procedure

Innovative endoscopic treatment for gastroparesis

G-POEM stands for gastric peroral endoscopic myotomy. It is an innovative procedure to treat patients with gastroparesis, a condition where the stomach does not empty properly.

What is Gastroparesis?

Gastroparesis is a paralysis of the stomach or a stomach that empties slowly. In a normal stomach, the vagus nerve helps contract the stomach to move food into the small intestine.

With gastroparesis, the vagus nerve is not functioning and food does not move properly. Symptoms include:

  • Nausea
  • Vomiting
  • Bloating
  • Abdominal pain
  • Heartburn
  • Feeling full after eating a small amount of food

Your doctor will do a series of tests to diagnosis gastroparesis. Learn more about the symptoms, causes and other treatment options for gastroparesis.

Gastroparesis Surgery

Gastroparesis is a chronic condition. Medication and dietary changes may be used to manage symptoms. Sometimes, surgery is needed. G-POEM is just one type of gastroparesis surgery, and your doctor will help you decide whether it is right for you.

Understanding the G-POEM Procedure

G-POEM is a minimally invasive procedure that is done in an operating room. You are put to sleep for this procedure with general anesthesia. This procedure takes around an hour and a half to complete.

Endoscopic Procedure

Endoscopic surgery uses an endoscope, a long, flexible tube to reach the surgical site. During G-POEM, while you are asleep, the doctor will guide an endoscope into your throat and stomach. Then an incision is made and a tunnel created between the layers of the stomach in order to reach the tight pyloric muscle.

Myotomy

The “myotomy” in G-POEM refers to the type of incision. A myotomy is performed on the muscle. This is a permanent cut that creates an opening for food to pass freely into the small intestine. This procedure does not work on everyone so it is important to explore all options with your doctor.

You will undoubtedly have questions prior to your gastric peroral endoscopic myotomy. Your IU Health care team will be happy to talk through them with you, but here are some of the more frequently asked questions about G-POEM.

Do I have to stay the night in the hospital?

Yes. Your doctor will admit you for an overnight stay in the hospital to monitor you. After the procedure your doctor will order an upper gastrointestinal series (barium swallow) to make sure the surgical area is intact. This X-ray takes pictures of the entire stomach.

Once this is read by a radiologist, you will start on a full liquid diet. You will be given intravenous (IV) hydration and antibiotics before and after the procedure until you are discharged to home. Pain medication is sometimes needed but most patients have no pain the next day.

Your diet will progress to a soft diet after the first three days and then you will speak to one of our nurses on the phone to see how you are doing.

What happens when I go home? Going back to work?

When you go home, you will be given a diet to follow for the next month. Our nurses will call you at multiple intervals to check on your progress and answer questions.

You will resume all home medications when you go home unless otherwise instructed by your doctor. Along with your home medications, you will be given a course of antibiotics to finish over the next seven days to prevent infection.

All patients are given a lifting restriction of no more than 15 pounds for the first two weeks. You can return to light-duty work the day after your discharge. If you require a note for your profession, please ask your doctor.

Will I need to come back for more testing?

Yes. G-POEM patients come back for testing at six months, 12 months and 24 months after the procedure. This includes:

  • An upper endoscopy (EGD)
  • Endoflip
  • Four-hour gastric emptying scan
  • Antroduodenal manometry

These tests are all of the same tests that you had done to qualify for surgery. It is important to follow up with testing as sometimes symptoms return or do not go away totally.

Your doctor will discuss the findings with you around two weeks after testing.

After Your G-POEM Procedure

You will undoubtedly have questions prior to your gastric peroral endoscopic myotomy. Your IU Health care team will be happy to talk through them with you, but here are some of the more frequently asked questions about G-POEM.

Do I have to stay the night in the hospital?

Yes. Your doctor will admit you for an overnight stay in the hospital to monitor you. After the procedure your doctor will order an upper gastrointestinal series (barium swallow) to make sure the surgical area is intact. This X-ray takes pictures of the entire stomach.

Once this is read by a radiologist, you will start on a full liquid diet. You will be given intravenous (IV) hydration and antibiotics before and after the procedure until you are discharged to home. Pain medication is sometimes needed but most patients have no pain the next day.

Your diet will progress to a soft diet after the first three days and then you will speak to one of our nurses on the phone to see how you are doing.

What happens when I go home? Going back to work?

When you go home, you will be given a diet to follow for the next month. Our nurses will call you at multiple intervals to check on your progress and answer questions.

You will resume all home medications when you go home unless otherwise instructed by your doctor. Along with your home medications, you will be given a course of antibiotics to finish over the next seven days to prevent infection.

All patients are given a lifting restriction of no more than 15 pounds for the first two weeks. You can return to light-duty work the day after your discharge. If you require a note for your profession, please ask your doctor.

Will I need to come back for more testing?

Yes. G-POEM patients come back for testing at six months, 12 months and 24 months after the procedure. This includes:

  • An upper endoscopy (EGD)
  • Endoflip
  • Four-hour gastric emptying scan
  • Antroduodenal manometry

These tests are all of the same tests that you had done to qualify for surgery. It is important to follow up with testing as sometimes symptoms return or do not go away totally.

Your doctor will discuss the findings with you around two weeks after testing.

Patient Stories for G-POEM Procedure