The esophagus is a muscular tube that carries food and liquids from the mouth to the stomach. If the esophagus is too narrow, swallowing problems can occur.
During an esophageal dilation, the doctor places a tube-shaped device into the esophagus to widen the narrow part. This procedure makes it easier to swallow and get proper nutrition.
Reasons for Procedure
Esophageal dilation is done to treat a narrowing in the esophagus, called a stricture. This happens when there is a build-up of scar tissue, which may be due to:
- Gastrointestinal reflux disease (GERD)
- Injury to the esophagus
- Eosinophilic esophagitis
- Birth defects or after repair of defects of the esophagus
Esophageal dilation widens the esophagus. Some may need the procedure repeated within a year.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Bleeding (including coughing up blood or having bloody vomit)
- Chest pain
- Shortness of breath
- Soreness and pain in the throat
- Nausea and vomiting
- Severe swelling in the middle part of the chest
- Inhalation of stomach contents
- Tear or hole in the esophageal lining (can lead to bleeding and the need for more surgery)
Some factors that may increase the risk of complications include:
- Smaller stricture
- Heart or lung problems
Talk to your doctor about these risks before the procedure.
What to Expect
Prior to Procedure
In the days leading up to the procedure:
- Arrange for a ride to and from the hospital. Also, ask someone to help you at home.
- If instructed by your doctor, avoid eating or drinking for 6 hours before the procedure.
Talk to your doctor about:
- Any allergies
- Whether you need antibiotics before the procedure
- Any medications, herbs, and dietary supplements that you take—You may be asked to stop taking some medications up to one week before the procedure.
In some cases, general anesthesia will be used. This will block any pain and keep you asleep during the procedure. A local anesthetic may also be used to numb the esophagus, and a sedative will be given to relax you.
Description of Procedure
An esophageal dilation will usually be done along with an endoscopy. During an endoscopy, the doctor will place a slim, flexible tube into the mouth and then into the esophagus. The tube has a tiny light and a camera attached. This will allow the doctor to view your esophagus on a monitor.
An imaging technique called fluoroscopy may also be used, especially when the dilator is being placed. With fluoroscopy, x-rays images of your esophagus will be sent to a monitor for viewing.
After observing the stricture, the doctor will decide which type of dilator to use to stretch the stricture. These tube-shaped devices are available in different sizes and styles. Depending on how severe your stricture is, the doctor may choose a plastic dilator or a balloon dilator .
For the plastic type, the doctor will use a scope to place a guide wire into the esophagus. This will allow the doctor to place the dilator in the correct spot. The scope will be taken out, and a tapered dilator will be placed through your mouth and throat to the site of the stricture. Depending on your condition, the doctor may need to do this process several times using wider dilators.
If a balloon device is used, it will also be inserted using a scope. Once the dilator is in the correct position, the doctor will inflate the balloon to a certain size to widen the stricture.
Immediately After Procedure
About 15 minutes, but timing will depend on the size of the stricture
In most cases, you will not have any pain or discomfort during the procedure. In the days that follow, you will have a sore throat.
You will be monitored in the recovery room. The hospital staff will check to make sure your gag reflex is working normally. The gag reflex is your body’s natural reaction when something too large enters the back of the throat. It is your body’s way to protect you from choking.
Do the following to help ensure a smooth recovery:
Take special precautions during the first 24 hours:
- Rest when you get home.
- Slowly return to your normal diet. Begin with clear fluids and then eat soft foods that are not too hot.
- Do not drink alcohol.
- Do not drive or operate any machinery.
- If you have been diagnosed with GERD, take acid-suppressing medications as prescribed.
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Coughing up blood or vomiting blood after you or your doctor expect it to stop
- Pain in the esophagus
- Difficulty swallowing or breathing
- Nausea or vomiting
- Chest pain
If you think you have an emergency, call for emergency medical services right away..
- Reviewer: Daus Mahnke, MD
- Review Date: 06/2016 -
- Update Date: 06/18/2014 -