Per Oral Endoscopic Myotomy(POEM) is the treatment of choice for achalasia.Beyond clinical efficacy, evaluating quality of life and symptom progression is a crucial indicator of the real benefit to patients.This study aims to analyze the effectiveness of POEM using symptom scores(GerdQ,achalasia-specific questionnaire)and different dimensions of the SF-36,three months after the procedure.

A prospective, descriptive, and analytical study was conducted on 28patients,evaluated before and three months after POEM. Participants completed three questionnaires:

1-GerdQ,

2-Achalasia-specific questionnaire,

3-SF-36, covering its main dimensions: physical functioning, physical and emotional role limitations, vitality,mental health,social functioning,bodily pain,general health,and health change.Statistical analyses were based on paired t-tests to compare pre- and post-procedure scores. Correlations between score changes (Δ) were studied using Pearson’s r. The significance threshold was set at p < 0.05.

Twenty-eight patients were evaluated before and three months after POEM. Analysis of symptom scores and quality of life revealed a significant improvement in all parameters studied.The GerdQ score significantly decreased from 10.89 ± 2.1 to 5.46 ± 1.8 at 3 months post-POEM (p < 0.001).The achalasia-specific questionnaire also showed a marked reduction in symptoms, from 26.3 ± 5.2 to 15.7 ± 4.9 (p < 0.001).Regarding quality of life (SF-36), all dimensions improved significantly:

• -Physical functioning: 46.1 → 80.0; p < 0.001
• -Physical role limitations: 16.1 → 75.9; p < 0.001
• -Emotional role limitations: 19.0 → 73.8; p < 0.001
• -Vitality: 32.0 → 64.1; p < 0.001
• -Mental health: 41.4 → 72.7; p < 0.001
• -Social functioning: 39.5 → 69.7; p < 0.001
• -Bodily pain: 27.3 → 71.3; p < 0.001
• -General health: 31.3 → 68.5; p < 0.001
• -Health change: 18.6 → 64.3; p < 0.001

The overall SF-36 components showed significant improvement: the physical component summary (PCS) increased from 30.2 ± 9.4 to 50.2 ± 9.0 (p < 0.001), and the mental component summary (MCS) from 27.1 ± 11.6 to 46.0 ± 12,6 p < 0.001).Correlation analysis between score changes (Δ) at 3 months showed:

• -A moderate and significant correlation between the decrease in reflux symptoms (ΔGerdQ) and the reduction of achalasia-specific symptoms (ΔAchalasia): r = 0.497; p = 0.008.
• -The change in the achalasia-specific score was strongly negatively correlated with the improvement in the physical component (ΔPCS): r = −0.595; p = 0.001, indicating that a substantial reduction in achalasia symptoms is associated with significant physical quality-of-life gains.
• -No significant correlation was observed between the mental component (ΔMCS) and other scores (ΔGerdQ, ΔAchalasia, ΔPCS), suggesting that short-term mental improvement is independent of symptom changes.

Our study confirms the effectiveness of POEM in improving reflux symptoms, achalasia manifestations, and all dimensions of quality of life, both physical and psychosocial. The mental component at three months, however, may require more time to show improvement.