Esophageal Dilation

Procedure Questions

What is Esophageal Dilation?

The esophagus can sometimes become narrowed and can cause problems swallowing. Patients report that food feels like it is “stuck” in the chest, causing discomfort or pain.

Esophageal dilation allows your doctor to relieve that. During the procedure your doctor will stretch a narrowed portion of your esophagus.

Procedure Bullet Points

Esophageal Dilation:

  • Can be performed using several methods
  • May require sedation or anesthesia
  • Is performed in-office

If Esophageal Dilation is performed as part of an endoscopy, your doctor will decide using a dilator with or without a guided wire or a balloon dilator to stretch your esophagus.

Using a wire guided dilator, your doctor will perform endoscopy and place a flexible wire across the obstruction in your esophagus. The endoscope is removed and the wire left in place. Your doctor will guide dilators down the esophagus and run it over the obstruction. At the end of the exam, the wire is removed.

Using a balloon dilator, your doctor will place a deflated balloon through the endoscope and across the obstruction. As the balloon is inflated, it stretches and breaks the obstruction.

If performed without an endoscopy, your doctor will use what’s called simple dilator. They are flexible dilators that increase in thickness. One or more are passed through the esophagus and over the obstruction. This is the quickest method of Esophageal Dilation. Esophageal dilation is very safe, but as with any medical procedure there are risks.

They include:

  • Bleeding at the site of dilation
  • Perforation of the esophagus

The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of stomach acid occurring in patients with heartburn.

Less common causes of esophageal narrowing are webs or rings caused by excess tissue, cancer of the esophagus, scarring after radiation treatment or a disorder in the movement of the esophagus.

Your doctor will give you instructions to prepare for the procedure. Most likely, you will be asked to fast for at least 6 hours beforehand to ensure an empty stomach.

Some patients are also given antibiotics in preparation.

Inform your doctor of:

  • Any medication that you take regularly, especially;
    • aspirin products
    • arthritis medications
    • blood thinners (such as Warfarin or Heparin)
    • Clopidogrel
    • Insulin
  • Any known allergies to medication
  • Any medical conditions that will require special attention, such as;
    • heart conditions
    • lung conditions
    • any other major conditions

If performed as part of an endoscopy you’ll need to plan for ride home from the office as it is not advised for patients to drive for the remainder of the day due to effects from the medication. It’s important to follow all of your doctor’s instructions.

If performed as part of an endoscopy your doctor will pass an endoscope down your throat and into your upper GI tract. Then your doctor will determine whether to use a dilating balloon, or a tapered bougie dilator with our without a guiding wire depending on the conditions existing in your esophagus.

Dilation can also be performed during endoscopy without the use of a guided wire. This is a common practice in some endoscopy centers.

Your doctor might also perform the procedure without an endoscopy by passing a tapered dilating instrument through your mouth and into the esophagus.

In both cases you’ll likely be given a local anesthetic or a sedative and you may feel some discomfort or mild pain in your throat or chest.

After the dilation is done, you will be observed for a short period of time and then allowed to return to your normal lifestyle. If you received sedatives, you should have a ride prepared as the sedatives may impair your judgement.

You’ll likely:

  • Be able to drink when the anesthetic wears off, unless instructed otherwise by your doctor.
  • Be able to eat the next day, unless instructed otherwise by your doctor.
  • Experience a mild sore throat.

You may need to return for a repeat dilation depending on the degree and cause of the narrowing to your esophagus. Repeat dilations also allow the process to be performed gradually and decrease the risk of complications.

If the narrowing was due to acid reflux, your doctor may go over acid suppressing medications with you.

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