Esophageal Dilation

Dayton Gastroenterology, Inc. » Services » Procedures » Esophageal Dilation

Esophageal Dilation is the careful stretching of the wall of the esophagus in order to provide relief from narrow areas in your esophagus that can cause difficulty swallowing.

Reasons for the Exam

Some patients experience a narrowing in the esophagus, called a stricture, that can cause difficulties swallowing and make food feel like it is “stuck.” Strictures most commonly form due to scarring of the esophagus from acid reflux. Other reasons for strictures include webs or rings in the esophagus (which are thin layers of excess tissue), esophageal cancer, scarring after radiation treatment, or a disorder in the way the esophagus moves (also called a motility disorder). When this occurs, a gastroenterologist needs to dilate, or stretch, the narrowed area by performing an Esophageal Dilation.

Equipment

The endoscope is a thin flexible lighted tube which is passed through the mouth and is capable of seeing the upper GI tract. It contains a minute optically sensitive computer chip in the tip which transmits the signal onto a video screen. Dials permit the physician to steer the instrument in every direction. A channel through the instrument permits suctioning or the collection of samples. Other instruments can be passed through this channel, such as dilators or deflated balloons.

Benefits

Esophageal Dilation allows patients relief from the feeling that food gets “stuck” in their throat or from other difficulties when swallowing. It can be performed safely and with minimal discomfort for you. It allows the doctor to perform a specific Gastroenterology treatment that relieves obstructions and enlarges the strictures.

Risks and Side Effects

Endoscopy is safe. While no test is 100% accurate and infrequently an EGD can miss abnormalities, complications can occur, but are rare. Your throat may feel sore for a day after dilation, but usually goes away within 24 hours. Localized irritation of the vein where the medication was injected may cause a tender lump lasting for several weeks, but this will go away eventually. Applying heat packs or hot moist towels may help relieve discomfort. Other potential risks include a reaction to the sedatives used and complications from heart or lung diseases. Major complications, e.g. perforation (a tear that might require surgery for repair) are very uncommon; they occur less than once in 4,000 tests. It is important for you to recognize early signs of any possible complication. If you begin to run a fever after the test, have trouble swallowing or have increasing throat, chest or abdominal pain, let your doctor know immediately, as complications could involve hospitalization, emergency surgery, or, in an exceptionally rare case, death.

Preparation

Preparing for Esophageal Dilation is similar to preparing for an EGD. The doctor needs a clear view, so the stomach must be empty. It is very important that you have nothing to eat or drink after midnight the evening before the procedure. If your procedure is scheduled in the afternoon, you may be instructed to have an early clear liquid breakfast. An exception to this is prescription medication. You can take these on the morning or afternoon of the exam with a few sips of water. It is especially important to take any high blood pressure or heart medication. If you take any of the following medications, notify our office prior to the procedure because they may need to be stopped or the dosage may need to be adjusted. View all Esophageal Dilation Preparation Instructions.

Before the Procedure

  • If you are on blood thinner medication, such as Coumadin or Warfarin, it is important to let us know well in advance of your appointment. If you are taking these medications and have not already given that information to our office, please call immediately. A member of your care team will contact you about instructions about taking your blood thinner prior to this procedure.
  • YOU MUST HAVE SOMEONE TO DRIVE YOU HOME OR THE DOCTOR WILL NOT DO THE PROCEDURE. If your driver does not stay during your procedure, you will need to provide a phone number to contact that person. Using a small amount of water, take your prescription medications as you usually do unless you have been instructed to “hold” the medication prior to the procedure. It is very important that you take your blood pressure or heart medication as usual.
  • Bring a list of your current medications and any allergies to medication.
  • Bring your insurance cards with you.
  • If you are a diabetic, check your blood sugar at home before your procedure.
  • If you have an implanted cardiac defibrillator, it is very important that you bring the card identifying the device manufacturer, model and serial number.
  • Before the procedure begins, you will be asked to remove your glasses/contacts, dentures, hearing aids and jewelry. It is best to leave your jewelry at home.
  • Upon arrival, a brief medical history will be reviewed with you by a nurse. You will be asked to remove your clothing and change into a patient gown. Because this is a medical facility, it is kept at a lower temperature than you may keep your home. You, as well as your family members, may wish to bring a sweater or jacket for your comfort in the waiting area. Patients are permitted to wear socks during the procedure. Please refer to the “Instructions for Your Procedure” for directions about diet and fasting.
  • Try not to smoke for at least 4 hours before your procedure.

The Procedure

An intravenous (IV) catheter will be placed into your arm so that medications can be given for sedation. It is generally not a painful exam, but the sedation helps you to relax. Most of the effects of the sedation persist for 15-60 minutes, and you may not be able to recall the procedure afterwards. Your throat is usually anesthetized with a spray or liquid to minimize the gag reflex. The endoscope is then gently inserted into the upper esophagus and advanced through the upper digestive tract. The endoscope is small compared to the airway and does not interfere with normal breathing. You will be monitored closely throughout the exam. As the exam takes place, any additional necessary procedures are performed.

There are three different methods Dayton Gastro uses to perform Esophageal Dilation: the use of mercury-weighted dilators, a dilator over guidewire, and pneumatic dilation, or balloon dilation. All three methods are performed under sedation, and they can be performed as outpatient procedures in our Endoscopy Centers.

Mercury-Weighted Dilation

When your physician uses a mercury-weighted dilator, the dilators are blindly inserted into the esophagus by the doctor. The dilators are passed in sequentially increasing sizes in order to expand the obstructed area. Physicians must use precaution with patients who have narrow strictures, as they may curl near the obstruction.

Dilator over Guidewire

Performed during an upper endoscopy, the Dilator over Guidewire is performed by passing a guidewire into the stomach, past the obstruction. After the guidewire is in place, the dilators are introduced over the guidewire in sequentially increasing sizes. The upper endoscopy is sometimes used to evaluate the anatomy, as well as pass the guidewire.

Pneumatic Dilatation

Performed during an upper endoscopy, pneumatic dilatation, or balloon dilatation, is when the doctor inserts a deflated balloon into the area of the narrowing, then uses air to inflate the balloon to a certain pressure that is pre-set for a given circumference.

After the Procedure

After your Esophageal Dilation, you will remain in the recovery room area for one-half to one hour after the procedure, depending on your vital signs and level of consciousness. You may feel bloated from the air used during the procedure. The medication given to you during the procedure may affect your reflexes and judgment. You should not drive a car, operate machinery, or make any legally binding decisions for the remainder of the day. Drinking is allowed when the anesthetic no longer causes numbness in your throat, unless you are instructed otherwise by your doctor. Some people experience a minor sore throat for the remainder of the day. You will most likely be allowed to resume eating the next day.

Results

In most circumstances, your doctor can inform you of your test results on the day of the procedure. Your doctor will also be able to tell you if you need to repeat the procedure, and potentially how many more time the procedure needs repeated.

Repeat Dilations

It is common for patients to require more than one dilation to enlarge your esophagus. The number of procedures depends on the degree and the cause of the narrowing in your esophagus. Dilation must be performed gradually in increments in order to decrease the risk of complications. Once the stricture is completely dilated, you may not require further dilations.

Dayton Gastroenterology, Inc.

  • Beavercreek (Sylvania) Office & Endoscopy Center - 75 Sylvania Drive, Beavercreek, OH 45440 Phone: 937-320-5050 Fax: 937-320-5060
  • Beavercreek (Indian Ripple) Office & Endoscopy Center - 4200 Indian Ripple Road, Beavercreek, OH 45440 Phone: 937-320-5050 Fax: 937-320-5060
  • Englewood Office & Endoscopy Center - 9000 N. Main Street Suite 405, Englewood, OH 45415 Phone: 937-320-5050 Fax: 937-320-5060
  • Miamisburg Office - 415 Byers Road Suite 100, Miamisburg, OH 45342 Phone: 937-320-5050 Fax: 937-320-5060

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