Help explain this to me...

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Hi all,

I had a POEM surgery in 2016. I took another barium swallow a few months ago, consultant wasnt happy about my results. He said there was "no relaxation on smooth muscle"??? So today i took a high resultion manometry and stomach ph test. The doctor told me I had very low sphinter pressure???? As i lay here semi upright in bed my ph is reading 3.1 so there is definately acid in my E.

Can anyone explain these terms to me or what will likely happen next???

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  • Posted

    Smooth muscle, as I understand it, is the muscle system that operates automatically rather than from any effort on our part, and the peristaltic muscles affecting the swallowing system are like this.   I think you need to be very careful about interpreting this report yourself (or in asking us!), as it is the doctors who will be able to tell you.   

    ​When the muscles are cut during POEM or equivalent operations, the oesophagus can work largely through gravity, so it would not be surprising, perhaps, that the normal pulses of progressive pressure are different or absent.   But it would need somebody experienced with POEM procedures to know whether you were normal  or unusual for this result after the procedure.   The operation might explain the low pressure in the sphincter valve between the oesophagus and the stomach that normally prevents the acid from rising.   POEM does tend to result in more acid rising into the oesophagus;  the equivalent conventional procedure involves a fundoplication, wrapping the top of the stomach around the base of the oesophagus to recreate this valve effect.

    ​pH readings in relation to acid and alkali run on a range from 0 to 14 with highest readings being most alkali, and lowest readings most acid, and 7 being neutral.

    ​There would normally be a discussion with your specialist about what this means for you.   Did you return to hospital because you had further problems?   If it is the acid that is the problem, medication or an adjustment to the dose might be the approach they suggest.   If it is renewed swallowing problems, the manometry should give an indication about where the blocks are occurring.

  • Posted

    I hate to say bit should of looked into the robotic heller surgery you might needed to have you stomach pulled over your spincher to help keep acid from entering your esphougus. My surgeon told me this and why he don't do anymore POEM. Good luck and ask your doc about it. I am doing fine I do have to watch what i eat.


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