Esophageal dilation is a procedure that is performed to widen the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. Esophageal stricture, or narrowing of the esophagus, may be caused by different conditions which may damage the lining of the esophageal tissue, resulting in uncomfortable and sometimes painful symptoms. During the esophageal dilation procedure, the esophagus is stretched or dilated, which helps to alleviate the swallowing difficulties caused by esophageal stricture.
If patients are experiencing swallowing difficulties, they should consult with a physician to seek relief from uncomfortable symptoms. Initially, the physician will investigate the underlying cause of the symptoms by performing a physical examination and diagnostic tests that may include:
- Blood tests
- Barium swallow
A biopsy of esophageal tissue may also be performed. If an esophageal stricture is diagnosed, the patient may initially be treated with medication or may proceed directly to esophageal dilation. However, if medication has been unsuccessful in treating swallowing difficulties and uncomfortable symptoms, an esophageal dilation may be recommended.
Candidates for Esophageal Dilation
Patients with a narrowed esophagus often suffer from difficulty swallowing. In severe cases, food may become lodged in the esophagus. Esophageal dilation is an effective treatment option for these troubling symptoms that may be caused by:
- Gastroesophageal reflux (GERD)
- Cancer of the esophagus
- Esophageal rings or webs
- Swallowing of toxins, such as lye or battery acid
- Esophageal motility disorder
- Eosinophilic (allergic) esophagitis
A narrowed esophagus may also be caused by scarring that occurs as a result of a previous procedure such as an endoscopy or radiation treatment. In some cases, an esophageal stricture may be hereditary and the esophagus may be fully or partially blocked at birth.
The Esophageal Dilation Procedure
Prior to the procedure, the patient may be sedated with anesthesia. The physician may also apply an anesthetic spray to the back of the throat. A thin, flexible tube with a light and camera attached (endoscope) is passed through the mouth into the esophagus (see upper GI endoscopy). A fluoroscopy may also be used during the procedure, so that X-ray images of the esophagus can be viewed on a monitor. The esophageal dilation may be performed with a plastic dilating device or with the assistance of an inflatable balloon dilator to widen the passageway. If a plastic dilating device is used, the physician may use a scope to place a guide wire into the esophagus, which then guides the dilator in the correct spot, or uses real-time X-rays (fluoroscopy) to guide the dilator. If a balloon device is used, it is also inserted through the scope, and once it is properly positioned, the physician inflates the balloon to widen the stricture. The esophageal dilation procedure takes about 15 to 30 minutes to perform.
Recovery from Esophageal Dilation
After the esophageal dilation, patients may experience a mild sore throat. Most patients do not experience any other symptoms after the procedure and can resume a regular diet the next day. Patients may be monitored in a recovery area, especially after receiving anesthesia, and should arrange for a ride home after the procedure. Since it is commonly performed as an outpatient procedure, patients can often return home the same day as the procedure.
Risks of Esophageal Dilation
Although complications of an esophageal dilation are rare, they may include:
- Perforation or tear in the esophageal lining
- Reaction to anesthesia
Early signs of complications may include fever, chest pain, difficulty breathing or swallowing, or black stools. If patients experience any of these symptoms, they should contact their doctor immediately.
An esophageal dilation is an effective procedure that can help to alleviate the symptoms of esophageal stricture. However, depending on the cause and severity of the condition, repeated dilations may be necessary. If the narrowing of the esophagus was initially caused by GERD or acid reflux, acid-suppressing medications may be prescribed to decrease the risk of an esophageal stricture recurrence.
To learn more about our Gastroenterology Services, please contact us today to schedule an appointment!