Achalasia cardia is an idiopathic neurodegenerative disorder of the esophagus characterized by impaired relaxation of the lower esophageal sphincter and loss of normal peristalsis. Although rare (2.92 per 100,000 adults and 0.11 per 100,000 children), achalasia has a significant clinical and social burden. Progressive dysphagia, regurgitation, chest pain, and weight loss substantially reduce patients’ quality of life and lead to nutritional deficiencies, while the risk of esophageal carcinoma remains elevated. Conservative therapy provides only limited and short-term relief.Peroral endoscopic myotomy (POEM) has emerged as a modern, minimally invasive treatment demonstrating high efficacy and safety. In Kazakhstan, POEM is primarily performed in national research centers; however, experience from private hospitals remains underreported, highlighting the relevance of this study.

Diagnosis of achalasia was established buy barium x-ray esophagography, EGD and symptom assessment Eckardt score. The study included 19 patients (7 men and 12 women) with stages I–III achalasia. The mean age was 43.5 years (range: 23–59), and the mean body mass index (BMI) was 24.6 kg/m² (16.9–26.4). Hospitalization lasted 4–7 days. The mean procedure time was 50 minutes (range: 45–120), with an average myotomy length of 6 cm (5–9 cm).

In a private clinic setting without government funding, POEM was successfully performed in all 19 patients. The preoperative mean Eckardt score was 7.85, reflecting marked dysphagia, regurgitation, chest pain, and weight loss. The average body weight before surgery was 58 kg (48–85 kg), with weight loss ranging from 2 to 30 kg.Following POEM, the mean Eckardt score decreased to 1.26. All patients reported significant symptom resolution, including improved swallowing, chest comfort, and normalization of sleep. No serious complications occurred. A complete regression of dysphagia, regurgitation, and chest pain was achieved in all cases, with only one patient experiencing recurrence within one year postoperatively.

Our findings confirm that POEM can be safely and effectively performed not only in national or academic centers but also in private clinical settings, provided adequate endoscopic expertise and equipment are available. The outcomes in this study are comparable to international data, underscoring that procedural success depends primarily on adherence to technical standards rather than institutional status.This experience demonstrates that private hospitals can play a pivotal role in expanding access to innovative, minimally invasive treatments for achalasia, ultimately improving healthcare quality and reducing disparities in care availability.