Per-oral endoscopic myotomy has been used as a treatment method of esophageal achalasia.
Patients who undergo POEM as a treatment of achalasia are often presented with development of
reflux as a side effect of the surgery. Patients are then in need to use proton pump
inhibitor drugs as a long term treatment of the reflux symptoms.
Physiotherapy aimed on the strengthening of diaphragm and lower esophageal region is
effective in gastroesophageal reflux disease. Therefore we are expecting positive effect of
physiotherapy in post POEM patients with reflux symptoms and the possible reduction of PPI
drug usage need.
The aim of the study is to objectify the effect of physiotherapy, to describe in detail the
used physiotherapeutic techniques and to develop practical guidelines for the treatment of
patients after POEM with GERD.