There is evidence regarding the occurrence of dyspeptic symptoms due to gastroparesis following thoracic surgeries and esophagectomies, as a consequence of iatrogenic vagal nerve injury. Peroral endoscopic myotomy (POEM) involves sectioning the esophagogastric muscularis propria, often transmurally, which could affect the vagal plexus and, therefore, produce gastroparesis and dyspepsia symptoms and as an adverse event.

The aim of our study was to evaluate the prevalence of dyspepsia symptoms in patients undergoing POEM at our center.

Cross-sectional study including patients who underwent POEM at our center (June 2018 – December 2024). Demographic, clinical, endoscopic, and manometric variables were collected. Through telephone interviews, the presence of dyspeptic symptoms before and after the procedure was assessed, as well as the perceived quality of life after the intervention using a Likert scale (0-4).

A total of 112 patients who underwent POEM between 6 and 78 months prior to the study were evaluated. Ninety-four percent of patients had an Eckardt Score ≤3, with high or very high improvement in quality of life (score 3-4) in 90% of patients. Thirty-two patients (28%) with dyspeptic symptoms were identified, of which 25 (78%) presented postprandial distress-type symptoms (fullness/early satiety). Among patients with dyspepsia, 15 patients experienced symptoms before the procedure, while 17 cases (15%) corresponded to new-onset dyspepsia. No statistically significant associations were found between any variables and the occurrence of dyspepsia.

Up to 15% of patients undergoing POEM experienced de novo post-POEM dyspeptic symptoms. Seventy-eight percent of these patients presented fullness/early satiety, possibly related to iatrogenic vagal nerve injury. However, quality of life manifestly improved in 90% of cases.