Esophageal Dilation

Esophageal dilation is the careful stretching of the wall of the esophagus in order to provide relief from narrow areas in your esophagus that can cause difficulty swallowing.

Why Do I Need an Esophageal Dilation?

Some patients experience a narrowing in the esophagus called a stricture that can cause difficulties swallowing and make food feel like it is stuck. Strictures most commonly form due to scarring of the esophagus from acid reflux. 

Other reasons for strictures include esophageal webs or rings which are thin layers of excess tissue, esophageal cancer, scarring after radiation treatment, or a disorder in the way the esophagus moves (also called a motility disorder). When this occurs, a gastroenterologist needs to dilate, or stretch, the narrowed area by performing an esophageal dilation.

What Are the Benefits of an Esophageal Dilation?

Esophageal dilation allows patients relief from the feeling that food gets stuck in their throat or from other difficulties when swallowing. It can be performed safely and with minimal discomfort. It allows the doctor to perform a specific gastroenterology treatment that relieves obstructions and enlarges the strictures.

Is There an Alternative to an Esophageal Dilation?

No.

Are There Side Effects and/or Risks to an Esophageal Dilation?

Endoscopy is safe. While no test is 100% accurate, and infrequently an EGD can miss abnormalities, rare complications can occur. 

• Your throat may feel sore for a day after dilation but usually improves within 24 hours.
  
• Localized irritation of the vein where the medication was injected may cause a tender lump lasting for several weeks, but this will go away eventually. Applying heat packs or hot moist towels may help relieve discomfort. 
• You may experience a reaction to the sedatives used and complications from heart or lung diseases. 
• Major complications, e. g., perforation (a tear that might require surgical repair), are very uncommon; they occur in less than one in 4,000 tests.
  

It is important for you to recognize early signs of any possible complication. If you begin to run a fever after the test, have trouble swallowing or have increasing throat, chest or abdominal pain, let your doctor know immediately, as complications could involve hospitalization, emergency surgery, or, in an exceptionally rare case, death.

What Will Happen When I Arrive for My Esophageal Dilation?

• A brief medical history will be reviewed with you by a nurse.
• You will provide a list of any current medications you are taking along with any allergies you have to medications.
• You will be asked to remove your clothing and change into a patient gown.

What Will Happen During My Esophageal Dilation?

• An intravenous (IV) catheter will be placed into your arm so that medications can be given for sedation. It is generally not a painful exam, but the sedation helps you to relax.
• Most of the effects of the sedation persist for 15-60 minutes, and you may not be able to recall the procedure afterwards. 
• Your throat is usually anesthetized with a spray or liquid to minimize the gag reflex.
•  The endoscope is then gently inserted into the upper esophagus and advanced through the upper digestive tract. The endoscope is small compared to the airway and does not interfere with normal breathing. 
• You will be monitored closely throughout the exam. 
• As the exam takes place, additional necessary procedures may be performed.

Dayton Gastro uses three different methods to perform esophageal dilation.

Mercury-Weighted Dilation

When your physician uses a mercury-weighted dilator, the dilator is blindly inserted into the esophagus and is passed in sequentially increasing sizes in order to expand the obstructed area. The dilators are passed in sequentially increasing sizes in order to expand the obstructed area. 

Dilator over Guidewire

The dilator over guidewire procedures is performed during an upper endoscopy by passing a guidewire into the stomach past the obstruction. After the guidewire is in place, the dilators are introduced over the guidewire in sequentially increasing sizes. An upper endoscopy is sometimes used to evaluate the anatomy as well as to pass the guidewire.

Pneumatic Dilation

Pneumatic or balloon dilation is performed during an upper endoscopy when the doctor first inserts a deflated balloon into the area of the narrowing and then uses air to inflate the balloon to a certain pressure that is pre-set for a given circumference.

What Will Happen After My Esophageal Dilation?

• You will remain in the recovery room area for one half to one hour after the procedure depending on your vital signs and level of consciousness. 
• You may feel bloated from the air used during the procedure. 
• The medication given to you during the procedure may affect your reflexes and judgment. 
• Following the exam, your physician will discuss the results with you and your loved ones. Your physician will also be able to inform you if you will need to repeat the procedure. Repeat procedures are common.
• You should not drive a car, operate machinery, or make legally-binding decisions for the rest of the day.

What Else Should I Know About My Esophageal Dilation?

• If you are on blood thinner medication, such as Coumadin or Warfarin, it is important to let us know well in advance of your appointment. If you are currently taking these medications and have not already given that information to our office, please call immediately. A nurse will contact you about instructions about taking your Coumadin prior to this procedure.
• YOU MUST HAVE SOMEONE TO DRIVE YOU HOME, OR THE DOCTOR WILL NOT DO THE PROCEDURE. If your driver does not plan to stay during your procedure, you will need to provide a phone number where that person can be contacted.
• Using a small amount of water, take your prescription medications as you usually do unless you have been instructed to hold off the medication prior to the procedure. 
• It is very important that you take your blood pressure or heart medication as usual.
• Bring your insurance cards with you.
• If you are a diabetic, check your blood sugar at home before your procedure.
• If you have an implanted cardiac defibrillator, it is very important that you bring the card identifying the device manufacturer, model, and serial number.
• You may wear your glasses, dentures, or hearing aids. It is best to leave your jewelry at home.

How do I prepare for my Esophageal Dilation?

Please click the button below to view the preparations for your Esophageal Dilation: