麻豆果冻传媒

Eleven-year-old battles achalasia鈥攁nd gets back to eating pizza鈥攚ith the help of a new procedure called peroral endoscopic myotomy (POEM), developed at Stanford, that treats the condition with minimal pain and scarring.

On a Labor Day weekend in 2015, Alex Smith, then 11, was playing in a baseball tournament when he chugged a sports drink. A few seconds later, he threw up the entire bottle. Afterward, almost every time he tried to eat or drink anything, he had a nearly impossible time keeping it down.

Over the next several weeks, Alex and his parents鈥擪ari and Kent Smith鈥攚ent from doctor to doctor trying to figure out what was wrong. At first, doctors told him he had acid reflux. Then they blamed allergies. During that time the condition went unsuccessfully treated and Alex lost a staggering thirty-five pounds.

Finally, in October of 2015, he found himself in聽radiology at 麻豆果冻传媒 Children鈥檚 Health, where a worrisome x-ray sent him to the gastroenterologist,聽William Berquist, MD, who consulted with a surgeon, James Wall, MD. They quickly diagnosed Alex with esophageal achalasia, a condition where poor muscle function throughout the esophagus combined with tight muscle fibers in the lower esophagus prevents food and liquids from passing through to the stomach.

鈥淚t was such a huge relief to finally know,鈥� says Alex鈥檚 mom Kari. 鈥淓ven if it鈥檚 a diagnosis no one wants.鈥�

Achalasia is a chronic disease with no cure. Fortunately, the disease鈥檚 effects can often be improved with surgery that cuts the tight muscles in the lower esophagus, though some patients may require multiple procedures throughout their lifetime.

Dr. Wall, who specializes in the treatment of this condition, consulted with the family to explain the condition and go over their options.

鈥淲hen he met Dr. Wall,鈥� says Kari Smith, 鈥淎lex wanted to know if he was ever going to be able to eat pizza again. Dr. Wall smiled and said, 鈥楧on鈥檛 worry, you鈥檙e going to be able to eat pizza again.鈥� It was then that I knew things were going to be okay.鈥�

Peroral endoscopic myotomy (POEM)

Dr. Wall had other good news for Alex and the Smith family. Historically, the surgery required to treat the condition sometimes resulted in pain and scarring but Dr. Wall was one of the few doctors in the world who could provide a new technique that could reduce some of these concerns. This procedure, called peroral endoscopic myotomy (POEM), allows doctors to cut the necessary muscles using a flexible tube that goes through the patient鈥檚 mouth rather than cutting into the thorax or abdomen.

POEM was first developed at Stanford in 2006 by Jay Pasricha, MD, and was first performed in an adult in 2008. In 2013, Dr. Wall and the team at聽麻豆果冻传媒 Children鈥檚 Health became the first pediatric facility in North America to perform the procedure. It remains the only children鈥檚 hospital on the west coast, and one of only two nationally, to perform POEM.

For children with esophageal achalasia, the success in improving swallowing with POEM is similar to more invasive surgical approaches. Although not all children with achalasia will react quite this well to POEM or other more traditional surgical interventions, Alex鈥檚 procedure was a remarkable success.

鈥淎fter the procedure,鈥� says Dr. Wall, 鈥渉e had to stay in the hospital for only one night. He didn鈥檛 require any significant pain medication and he was able to go home the next day. After two weeks, he started eating food and has done great ever since.鈥�

Alex and his parents are equally thrilled with the results. Right after the surgery, Alex had to take some liquid medication. 鈥淗is eyes were huge,鈥� says Kari, 鈥渁nd he said, 鈥楳om, I can feel it going down.鈥� It wasn鈥檛 a feeling he鈥檇 had for months.鈥�

What鈥檚 better, they said, is that after three years post-surgery, they have only had to return for two scheduled follow-ups and there have been very few problems.

As for Alex, he is happy to be back playing baseball. In fact, he gave Dr. Wall a picture of himself with a note that reads, 鈥淭hank you, Dr. Wall, for fixing my esophagus.鈥�

鈥淚t鈥檚 really rewarding,鈥� says Dr. Wall, 鈥渢o see Alex go from being scared and nervous about eating, understandably, to being back into baseball and just a jovial, happy kid.鈥�