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Patient identification for gastric peroral endoscopic myotomy

Gastric peroral endoscopic myotomy (G-POEM) is a promising, recently developed treatment option for gastroparesis. Gastroparesis is a complex medical condition in which a pyloric sphincter abnormality, along with other mechanisms, prevents the stomach from emptying completely into the small intestine. Many patients with gastroparesis treated by G-POEM—which relaxes the pyloric sphincter by cutting the pyloric muscles endoscopically, without the need for invasive surgery—have experienced dramatic improvements in their symptoms and quality of life. However, there is currently no metric to identify the patients most likely to benefit from this procedure, as the normal characteristics and distensibility of the pyloric sphincter have not been studied.
Sunil Dacha, MD, Assistant Professor of Clinical Medicine, is leading a prospective study that uses an endoluminal functional lumen imaging probe (EndoFLIP) to measure and compare the distensibility of the pyloric sphincter in patients with and without gastroparesis. Through this innovative research, Dr. Dacha aims to determine a normal distensibility index for the pyloric sphincter and, by comparing that with the distensibility index in patients with gastroparesis, to identify thresholds at which patients would most likely benefit from G-POEM. If successful, this research would allow physicians to target this treatment more precisely and to spare patients who are unlikely to benefit.
Sunil Dacha, MD