Esophageal Dilation: Indications and Complications

Esophagus is the food pipe that connects the mouth to the stomach. Some conditions cause narrowing of the esophagus leading to discomfort and pain and a feeling of food being stuck in their chest; esophageal dilation is done to provide relief from these symptoms.

Procedure

Esophageal dilation is done on an out patient basis. Your doctor will spray a local anaesthetic onto the back of your throat to numb it. Sedative might be administered via an intra venous line to help you relax. A thin tube with a camera and a light source is introduced into the upper gastrointestinal system via the mouth and esophagus to the stomach and duodenum. After examining the narrowing in the esophagus your doctor will decide whether to use a balloon dilator or a plastic dilator.

If your doctor decides to use a plastic dilator a guide wire will be passed through the endoscope, the movement of which is monitored with the help of fluoroscopy. The guide wire will help in placing the dilator in the correct place. Your doctor will then insert a tapered dilator into your esophagus via your mouth, the size of which depends upon the narrowing in your esophagus. This procedure may be repeated several times at different intervals to increase the size of the narrowing.

If your doctor decides to use balloon dilator, a deflated balloon device will be inserted into the esophagus with the help of an endoscope. Once it is positioned at the narrowing, your doctor will inflate the balloon to dilate the stricture.

Indications for Esophageal dilation

Esophageal dilation is used to treat narrowing of the oesophagus which may be seen in:

• Injury to esophagus
• Gastro-esophageal reflux disease (GERD): when the acidic contents of the stomach enter the esophagus due to reduced tone of the lower esophageal sphinchter
• Birth defects
• Scleroderma
• Eosinophilic esophagitis
• Injury to esophagus due to exposure to radiation
• Disorder of the motility of the esophagus
• Cancer of esophagus

Preparation

Empty stomach helps in better and safe examination during the procedure. Your doctor will advise you to stop eating and drinking six hours before the procedure. Your doctor would also like to know about the medications that you’ve been taking and may ask you to change the doe or stop taking some of them before the procedure like blood thinners and over-the-counter pain relief medications. You are advised to inform your doctor about any allergies to medication that you might have. Inform your doctor if you need to take antibiotics before a dental procedure.

Complications of Esophageal dilation

The complications encountered after oesophageal dilation are rare, they include:

• Perforation of esophagus
• Tear in the lining of esophagus
• Infection
• Pain in the chest
• Adverse effect due to sedatives

Recovery

After the procedure you will be allowed to return home on the same day. You are advised to arrange for someone to drive you home. You may resume drinking water after the effect of anaesthetic on the throat disappears. Most patients are able to resume eating food normally a day after the procedure. If you experience any of the following you are requested to contact your doctor:

• Fever
• Black or tar coloured stool
• Trouble breathing
• Difficulty swallowing
• Chest pain.

Resources:

• American Society for Gastrointestinal Endoscopy
• American Gastroenterological Association