Per-oral endoscopic myotomy (POEM) has become part of the standard of care for achalasia around the world. Although multiple studies have consistently demonstrated excellent short to mid-term clinical efficacy and safety profile, several questions remain, including how long term clinical outcomes, optimal POEM technique, and measures to reduce post-procedural reflux without compromising clinical efficacy. In this section, we provide an overview of some of the current challenges and comment on future directions of POEM as a therapy for esophageal motility disorders.
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