As an internationally recognized center for the treatment of complex esophageal diseases, we treat many conditions of or relating to the thoracic foregut in addition to esophageal cancers, GERD and Barrett’s esophagus.

Other diseases of the esophagus treated at Keck Hospital of USC include:

• Achalasia – a rare disorder of the esophagus in which the lower esophageal sphincter does not relax enough for the passage to open properly.

POEM Procedure - Keck Medical Center of USC is the only medical center in Southern California performing the POEM procedure for patients with achalasia. Candidates for the POEM procedure have achalasia or a similar motility abnormality without a large hiatal hernia or significant distortion of the esophagus. Patients with difficulty swallowing will initially be carefully evaluated to determine the cause of the problem. Testing with high-resolution manometry, a state-of-the-art system that determines if achalasia is present, is a key component of the evaluation. Patients with achalasia have several different treatments options, including POEM. All options are discussed with patients and are performed by Steven DeMeester, MD, at the Keck Medical Center of USC.

POEM benefits for patients include:

• No visible scars
• Next day discharge
• Immediate improvement in swallowing
• Minimal or no pain
• Minimal complications or need for repeat procedures

• Chronic Aspiration – aspiration occurs when food and/or liquids “go down the wrong pipe,” entering the airway. When this happens often over a long period of time, this is referred to as chronic aspiration.
• Cricopharyngeal Dysphagia – the cricopharyngeus is a horizontal muscle that separates the bottom of the throat from the top of the esophagus. When it malfunctions, it can cause difficulty swallowing.

Diagnosing Other Diseases of the Esophagus

As with other esophageal disorders, Keck Hospital of USC physicians employ a variety of tests to determine the best course of treatment for a particular malady. These tests may include:

• Esophageal pH monitoring – a test that measures how often and for how long stomach acid enters the esophagus from the stomach. A sensor at the end of a thin catheter is threaded through the patient’s nose and positioned in his or her esophagus, just above the lower esophageal sphincter. Once in place, the sensor detects stomach acid over a 24-hour period.
• Bravo Capsule pH Monitoring – a new, catheter-free pH test in which a capsule collects pH data and transmits it via radio waves to a small external receiver worn by the patient.
• Pharyngeal monitoring
• Upper Endoscopy – this procedure allows a physician to look inside the esophagus, stomach, and duodenum (part of the small intestine). During an upper endoscopy, the patient swallows a thin lighted tube called an endoscope, which transmits an image to a television monitor, so the physician can examine the lining of these organs.