PREcision MEDicine In Achalasia: How Long to Cut During POEM

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This observational cohort gathers data from adults with Type III achalasia, EGJ outflow obstruction with spastic features, Jackhammer esophagus, or distal esophageal spasm to see if pre-POEM testing guides the length of myotomy. Researchers will access participants’ standard medical records and collect questionnaires up to six times over two years. No experimental treatment is performed; the study observes current care decisions and outcomes. The aim is to understand if pre-procedure testing influences the surgical approach and short- to mid-term results. Participation requires consent and aligns with routine clinical care in multiple tertiary centers.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥ 18
2. Type III achalasia or EGJOO with spastic/hypercontractile features or Jackhammer Esophagus or Distal Esophageal Spasm
3. Eckardt Score \> 3

Exclusion Criteria:

* Exclusion:

  1. Prior POEM
  2. Prior surgical treatment for achalasia
  3. Endoscopic pneumatic dilation or lower esophageal sphincter botulinum toxin (botox) injection within 6 months
  4. Prior unrelated esophageal or upper gastric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy
  5. Prior endoscopic gastroesophageal intervention for obesity or GERD, such endoscopic sleeve gastroplasty or transoral incisionless fundoplication
  6. Known secondary achalasia related to malignancy (pseudoachalasia)
  7. Known eosinophilic esophagitis
  8. Diverticulum (\> 2 cm) in distal esophagus
  9. Megaesophagus
  10. Fibroinflammatory stricture of the esophagus due to any etiology (e.g., peptic, radiation, eosinophilic)
  11. Pregnancy
  12. Standard contraindications to general anesthesia
  13. Standard contraindications to endoscopic myotomy in the esophagus (e.g. untreated varices)
  14. Unwillingness or inability to consent for the study
  15. Anticipated inability to follow protocol

Where it's running

• University of California San Diego
  La Jolla, California, United States Recruiting
• University of Florida
  Gainesville, Florida, United States Recruiting
• Emory University
  Atlanta, Georgia, United States Recruiting
• Northwestern University
  Chicago, Illinois, United States Recruiting
• Massachusetts General Hospital
  Boston, Massachusetts, United States Recruiting
• Washington University
  St Louis, Missouri, United States Recruiting

Study contacts

• Study coordinator: Elizabeth Yan, BS
• Email: premedia.dcc@northwestern.edu
• Phone: 312-908-1723

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.