Figure 5: High-resolution manometry studies performed before and after a POEM procedure in a patient with type II achalasia.

Note the fragment of peristalsis proximal to the myotomy (double-headed arrow, extends 5 cm proximal to the EGJ) after per-oral endoscopic myotomy (POEM) that was not evident before myotomy. DCI, distal contractile integral; EGJ, oesophagogastric junction; IRP, integrated relaxation pressure.