Esophageal Dilation
Esophageal dilation is a procedure that is performed to widen the esophagus, which is the tube that carries food from the mouth to the stomach. Esophageal stricture (narrowing of the esophagus) is caused by various conditions that damage the lining of the esophageal tissue, resulting in uncomfortable and sometimes painful symptoms. During esophageal dilation, the esophagus is stretched (dilated), which helps to alleviate the swallowing difficulties caused by esophageal stricture.
A person who is having difficulty swallowing should consult a physician, who will investigate the underlying cause of the symptoms. The physician will perform a physical examination, and may order diagnostic tests that include the following:
- Blood tests
- Barium swallow
- X-ray
- Endoscopy
A biopsy of esophageal tissue may also be performed. If an esophageal stricture is diagnosed, the patient may initially be treated with medication. However, if medication is unsuccessful in treating swallowing difficulties and uncomfortable symptoms, an esophageal dilation may be recommended.
Candidates for Esophageal Dilation
A patient with a narrowed esophagus often suffers from uncomfortable symptoms that include pain or burning in the center of the chest, difficulty swallowing and regurgitation of food. In severe cases, food may become lodged in the esophagus. Esophageal dilation is an effective treatment for treating these symptoms, which may be caused by the following:
- Gastroesophageal reflux (GERD)
- Cancer of the esophagus
- Esophageal rings or webs
- Swallowing of toxins (such as lye or battery acid)
- Esophageal motility disorder
A narrowed esophagus can also be caused by scarring that is the result of a previous procedure such as endoscopy or radiation treatment. In some cases, an esophageal stricture is hereditary, and the esophagus is 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. 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 a balloon-inflated dilator to widen the passageway. If a plastic dilating device is used, the physician uses a scope to place a guide wire into the esophagus; the wire directs the dilator to the correct spot. If a balloon device is used, it is also inserted with a scope, and, once properly positioned, is inflated to widen the opening. Esophageal dilation takes about 15 to 30 minutes to perform.
Recovery from Esophageal Dilation
After the esophageal dilation, a patient may have a mild sore throat. Most patients do not experience any other symptoms, and can resume their regular diets the next day. Patients may be monitored in a recovery area, especially after receiving anesthesia, and should arrange for a ride home. Because it is often performed as an outpatient procedure, patients can often return home the same day.
Risks of Esophageal Dilation
Although complications of an esophageal dilation are rare, they may include the following:
- Perforation or tear in the esophageal lining
- Bleeding
- Reaction to anesthesia
Early signs of complications include fever, chest pain, difficulty breathing or swallowing, or black stool. A patient who experiences any of these symptoms should immediately seek medical advice.
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 the stricture's recurring.