What is a POEM Procedure?
Peroral Endoscopic Myotomy, or POEM, is a minimally invasive procedure primarily used to treat achalasia, a swallowing disorder caused by muscle dysfunction in the esophagus. The procedure involves cutting muscle fibers in the lower esophageal sphincter (LES) to improve food passage into the stomach. Following the prescribed post op POEM diet is essential for proper healing after this procedure.
The Phased Progression of the Post Op POEM Diet
Recovery after a POEM procedure involves a gradual dietary progression over several weeks. This phased approach helps prevent complications and ensures adequate nutrition during healing.
Phase 1: Clear and Full Liquids
Initially, patients are on a clear liquid diet for 24-48 hours, progressing to a full liquid diet for about 5-7 days. Clear liquids include things you can see through, while full liquids are thicker but still smooth.
- Clear Liquids: Water, clear broths, pulp-free juice, gelatin.
- Full Liquids: Milk, creamy soups, nutritional supplements, smooth yogurt.
Phase 2: Soft and Pureed Foods
Following the liquid phase, patients move to a soft diet. This involves foods that are soft, moist, and easy to chew, avoiding tough or dry items that could irritate the esophagus. This phase can last several weeks.
- Recommended Soft Foods: Mashed potatoes, scrambled eggs, well-cooked fish, cottage cheese, ripe bananas.
Phase 3: Gradual Reintroduction to a Regular Diet
Around 6 weeks post-procedure, patients can begin reintroducing more solid foods gradually. It's recommended to introduce new foods one at a time and in small amounts, monitoring for symptoms. Long-term tips include smaller, more frequent meals and thorough chewing.
Eating Tips for Recovery
- Eat slowly: Chew food completely.
- Small, frequent meals: Have 5-6 small meals daily.
- Stay upright: Sit upright while eating and for 30-60 minutes after meals.
- Drink between meals: Hydrate between meals, limiting liquids with meals.
- Fortify foods: Add protein or use whole milk and soft cheeses to boost nutrients.
Potential Issues: Reflux and Dumping Syndrome
POEM can sometimes lead to GERD, often manageable with medication and dietary changes, such as avoiding spicy or high-fat foods. Dumping syndrome can also occur in some patients, managed with small meals and limiting sugar. For further expert guidance and dietary resources, consider visiting the UCLA Health Esophageal Center.
Comparison of Post-POEM Diet Stages
| Feature | Clear Liquid Diet (Days 1-2) | Full Liquid Diet (Days 3-7) | Soft Diet (Weeks 1-6) | Regular Diet (After 6 Weeks) |
|---|---|---|---|---|
| Consistency | Transparent liquids | Smooth, non-chunky liquids | Soft, moist foods easily cut with a fork | Gradually reintroducing solid foods |
| Purpose | Allow initial healing, hydrate, prevent nausea | Provide more calories and nutrients | Continue healing, transition toward chewing | Return to normal eating habits |
| Examples | Broth, apple juice, gelatin, popsicles | Milk, cream soups, yogurt, protein shakes | Mashed potatoes, scrambled eggs, soft-cooked vegetables | Normal, well-chewed foods, adding high-fiber items gradually |
| Foods to Avoid | Anything with pulp, solids, dairy | Lumpy soups, solid foods | Tough meats, raw vegetables, hard bread | Spicy food, fatty food, alcohol, soda if causing issues |
Conclusion
The post op POEM diet is a structured plan progressing from clear liquids to a regular diet over several weeks. Following each stage is critical for healing and minimizing complications after a POEM procedure. Managing potential reflux and focusing on eating techniques like small meals and thorough chewing can help achieve the long-term benefits of the procedure.
