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Gastroparesis specialist

POP An Innovative Endoscopy Treatment for Gastroparesis

Gastroparesis is a disease in which the stomach cannot empty itself of food in a normal fashion. It's a common condition in people who have had:

  • Diabetes for a long time
  • Autoimmune disorders such as lupus or scleroderma.
  • Endocrine disorders such as hypothyroidism, abdominal surgery, medications, or arising spontaneously. 

How Gastroparesis works?

In a healthy digestive system, as food and fluid flow into your stomach, the pyloric sphincter closes and holds food in place so that the stomach digestive process can occur.

In its normal state, the vagus nerve contracts (tightens) the stomach muscles to help move the partially digested food and gastric juices from the stomach through the pylorus (the valve between the stomach and intestines) into the intestines for nutrient absorption.
Gastroparesis in stomach
Because of nerve damage, the stomach is not able to contract and overcome the pylorus which is the exit of the stomach. As a result, liquid and/or food cannot pass out of the stomach, and patients start to feel nausea and vomiting, belching and bloating, GERD, heartburn, early fullness when eating.
According to Dr. Arevalo, Per Oral Pyloromyotomy, or known as the POP procedure is a new endoscopic therapy that has recently shown great promise in improving both the patient symptoms and stomach emptying capability.

Typically, medical therapies (Reglan, among others), intrapyloric injections of botulinum toxin, gastric electrical stimulation therapy, and surgery are utilized to manage gastroparesis. Still, it is a frustrating condition because these medical and surgical procedures have been unsuccessful in resolving the disease’s symptoms or have been associated with complications. But, Dr. Arevalo performs the POP procedure for gastroparesis, where he goes through the mouth and advances into the stomach, cutting the pylorus (muscular valve that empties the stomach) without the need for an invasive surgical approach.

The POP surgery is performed in the operating room under general anesthesia.

The POP procedure is performed at world recognized digestive centers. It is proven to be safe, effective, and least invasive compared to other surgical therapies.
The stomach showing location of pylorus (red circle) ; source, Atlas of Human Anatomy. Frank H Netter, M.D.(2003).
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