Six weeks ago 67-year old John Galbreath welcomed death, rather than live one more day. Intense pain in his chest had left him nearly bedridden for four months. Galbreath had a condition called jackhammer esophagus, which made him feel like the name suggests -- like a jackhammer was going off in his chest.
"This is a condition where the esophagus spasms out of control and causes the patient to feel like they are having a heart attack 24/7," said Dr. Brian Dunkin, a minimally invasive surgeon at Houston Methodist Hospital. "With this condition, the esophagus does not contract properly causing patients to either have terrible chest pain or not be able to swallow food or fluid without it backing up into the esophagus. Now there's an easier way to fix the problem, and we are the only ones doing it in Texas."
The standard treatment for jackhammer esophagus is to perform surgery through the chest and can include up to five incisions. Sometimes a tube is placed in the chest for two to three days and there is a minimum of two weeks off work. Now there's a new minimally-invasive procedure to treat jackhammer esophagus and another disorder called achalasia, which is when the opening between the esophagus and stomach is blocked.
The procedure, Per Oral Endoscopic Myotomy or POEM, involves fixing the problems through the mouth instead of the chest. Like they did with Galbreath, surgeons operate through the mouth using a gastroscope, a thin flexible camera made to look into the esophagus and stomach. They drive the gastroscope down under the mucosa, the inner lining of the esophagus, all the way to the stomach wall and then cut the muscle of the lower esophagus and upper stomach to relieve the spasm and blockage. The POEM procedure leaves no surgical scars and is essentially pain free and patients can return to work in less than a week.
"Most of these patients don't realize how bad their situation has gotten until they can swallow again," Dunkin said. "The pain and heartburn from spasm or food and fluid backing up is virtually gone and they can get on with a normal life."
Galbreath says he felt like a new man as soon as he woke up from surgery.
"On Super Bowl Sunday, I was able to eat shrimp, chips and a hot dog with no pain or discomfort," Galbreath said. "After years of being misdiagnosed, I cannot tell you how happy I am that I was properly diagnosed and able to undergo this procedure."
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