From the Guidelines
After a POEM procedure, patients should start with a clear-liquid diet, then advance to a full-liquid diet, and eventually progress to a low-fiber, low-fat, solid-food gastroparesis diet, with small, frequent meals, as recommended by the most recent guidelines 1. The diet progression should be gradual, allowing the surgical site to heal properly while minimizing the risk of complications such as reflux or food impaction.
- Start with clear liquids for the first 24 hours
- Advance to full liquids for 5-7 days
- Progress to a low-fiber, low-fat, solid-food gastroparesis diet, with 5-6 small meals per day. It is also essential to consider pharmacologic acid suppression in the immediate post-POEM setting, given the increased risk of postprocedure reflux and esophagitis, as suggested by recent expert reviews 1.
- Patients should take proton-pump inhibitors (PPIs) for 8 weeks to decrease acid secretion and aid in mucosal healing, as recommended by the guidelines 1.
- Additionally, patients should review their diet and lifestyle to minimize the risk of complications, such as GERD, which is common among patients who undergo endoscopic or surgical myotomy with disruption of the LES 1.
- It is crucial to follow the dietary instructions provided by the healthcare team and to attend follow-up appointments to monitor the healing process and address any concerns or complications that may arise.
From the Research
Diet after POEM Procedure
There is limited information available on the specific diet recommendations after a POEM procedure. However, the following points can be considered:
- Post-POEM gastroesophageal reflux disease (GERD) is a known complication, and diet may play a role in managing symptoms 2, 3, 4, 5.
- Patients may need to make lifestyle changes, including dietary modifications, to manage post-POEM GERD 2, 5.
- Some studies suggest that proton pump inhibitors (PPIs) are effective in managing post-POEM GERD, but dietary changes may also be necessary 2, 3, 4, 5.
Key Considerations
- The exact cause and risk factors of post-POEM GERD are not fully understood, making it challenging to provide specific dietary recommendations 2, 3, 4, 5.
- More research is needed to determine the most effective dietary approaches for managing post-POEM GERD 2, 3, 4, 5.
- Patients should consult with their healthcare provider to determine the best course of treatment and dietary recommendations for their individual needs 2, 3, 4, 5.
Potential Dietary Modifications
- Avoiding trigger foods that can exacerbate GERD symptoms, such as citrus fruits, tomatoes, and spicy or fatty foods 4, 5.
- Eating smaller, more frequent meals to reduce symptoms of GERD 4, 5.
- Avoiding lying down after eating and elevating the head of the bed to reduce symptoms of GERD 4, 5.
- Considering a low-fat, high-fiber diet to help manage symptoms of GERD 4, 5.