Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience

Haruhiro Inoue, Showa University Koto Toyosu Hospital
Hironari Shiwaku, Fukuoka University
Yasutoshi Kobayashi, Jichi Medical University
Philip W.Y. Chiu, Chinese University of Hong Kong
Robert H. Hawes, Florida Hospital
Horst Neuhaus, Evangelisches Krankenhaus Düsseldorf
Guido Costamagna, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Stavros N. Stavropoulos, NYU Winthrop Hospital
Norio Fukami, Mayo Clinic Scottsdale-Phoenix, Arizona
Stefan Seewald, Klinik Hirslanden
Manabu Onimaru, Showa University Koto Toyosu Hospital
Hitomi Minami, Nagasaki University
Shinwa Tanaka, Graduate School of Medicine
Yuto Shimamura, Showa University Koto Toyosu Hospital
Esperanza Grace Santi, Salle University Medical Center
Kevin Grimes, University of Cincinnati College of Medicine
Hisao Tajiri, The Jikei University School of Medicine


It has been 10 years since peroral endoscopic myotomy (POEM) was reported for the first time, and POEM has currently become the standard treatment for achalasia and related disorders globally because it is less invasive and has a higher curative effect than conventional therapeutic methods. However, there are limited studies comparing the long-term outcomes of POEM with those of conventional therapeutic methods, particularly in the occurrence of gastroesophageal reflux disease (GERD) after therapy. With this background, we held a consensus meeting to discuss the pathophysiology and management of GERD after POEM based on published papers and experiences of each expert and to discuss the prevention of GERD and dealing with anti-acid drug refractory GERD. This meeting was held on April 27, 2018 in Tokyo to establish statements and finalize the recommendations using the modified Delphi method. This manuscript presents eight statements regarding GERD after POEM.