The Role That Peroral Endoscopic Myotomy (POEM) Could Play in the Treatment of Achalasia

Inclusion Criteria:

- Patients between the ages of 18 and 80 with achalasia diagnosed by a combination of
compatible symptoms, barium esophagography and high resolution manometry.

Exclusion Criteria:

- Patients who are poor surgical risks, have had previous treatment for achalasia or
esophageal or gastric surgery, have an epiphrenic diverticulum or are unwilling to be
followed in the protocol.

- Female patients are eligible if they are NOT pregnant or lactating AND ne of the
following criteria is met:

- The patient is surgically sterile (by means of hysterectomy/bilateral tubal ligation)

- The patient is at least one year postmenopausal (no menses for 12 months).

- The patient is using a highly effective method of contraception, if childbearing
potential, AND has a negative urine human chorionic gonadotropin beta subunit (ß HCG)
pregnancy test result during Screening, and prior to trial drug administration.

- Highly effective methods of birth control are defined as those which result in a low
failure rate when used consistently and correctly such as implants, injectables,
combined oral contraceptives, some IUDs, sexual abstinence or vasectomized partner.

- Withdrawal, single- or double barrier methods (including condoms) and rhythm methods
are NOT ACCEPTABLE methods of contraception for the purposes of this clinical trial
due to the high incidence of contraceptive failures with these methods.

- Vulnerable populations, such as those with diminished mental acuity, will be
excluded.