Esophageal Dilation

What is Esophageal Dilation and why is it performed?

Esophageal dilation is a procedure in which your doctor stretches a narrow area of your esophagus to reopen and expand the area. There are various techniques to perform this procedure. The procedure may be performed as part of a sedated endoscopy, or by an applied anesthetic allowing a weighted dilator to pass through your mouth and into the esophagus.

An esophageal dilation is most commonly performed to reopen the esophagus. Narrowing of the esophagus can occur due to many reasons, but the most common cause is scarring from the reflux of stomach acid and heartburn. Many patients with a narrowed esophagus have trouble swallowing which causes pain and discomfort. Less common causes include webs and rings, or thin layers of excess tissue, esophageal cancer, scarring due to radiation treatment, or a disorder of esophageal movement, called motility disorder.

Are there potential complications?

At TransSouth, we understand that every surgery and procedure can have complications and that those complications are a serious concern for all of our patients. While complications can occur from any procedure, even if it is performed correctly, the complications of esophageal dilation are extremely rare when performed by a specially trained doctor. Perforations of the esophageal lining occur in a small percentage of procedures and may require surgery. A tear in the lining of the esophagus may occur and result in bleeding. Side effects from sedatives or anesthesias may also occur, and it is important to recognize the side effects of early complications. Chest pain, fever, trouble breathing or swallowing, bleeding or black bowel movements may occur, and you should contact your physician immediately.

How do I prepare for Esophageal Dilation?

The safest and best exam calls for an empty stomach at the time of the procedure. No food or drinks, including water, should be consumed for at least six hours before the procedure is performed, and your doctor should inform you on when to start fasting.

At TransSouth Health Care we want to ensure you have the safest and best examination possible. To ensure this, you inform your doctor in advance about any medications you take, especially aspirin or other blood thinners, or clopidogrel. In most cases medications can be continued as usual, but you may need to adjust dosage before the procedure, which your doctor should advise you of. Any allergies or medical conditions, such as heart or lung disease, should be noted as well. Tell your doctor if you normally require antibiotics before any dental procedures, because you may need antibiotics before the procedure.

How is the procedure performed?

There are many ways in which to perform an esophageal dilation. You may be sedated along with an upper endoscopy, or your doctor may spray anesthetics on your throat and give you sedatives to calm you. Your physician will then pass the endoscope through your mouth into the esophagus and stomach. This will not interfere with your breathing, and your doctor will determine whether a dilating balloon or plastic dilators will be used to stretch your esophagus. Experiencing mild pressure in the back of your throat or chest during the procedure is normal during this procedure. Alternatively, your physician may choose to start with throat anesthesia and passing a tapered dilating instrument through your mouth to the esophagus. X-rays are also common practice during the dilation procedure, so do not be alarmed if X-rays are used.

After the procedure

After the procedure is finished, you will be observed for a period, and then allowed to return to your normal activities. If local anesthesia was used, you may resume drinking when the anesthetic wears off and feeling returns to your throat, unless instructed otherwise by your physician. Most patients may resume eating the next day, and experience no symptoms after the procedure. However, some patients experience mild throat soreness for the remainder of the day.

If sedatives were used, patients will typically be monitored in a recovery area until they are ready to leave. No driving is permitted after the procedure even if you are not tired. Arrange for someone to accompany you home, due to the sedatives which can affect your reflexes and judgment for up to a day.

Depending on the severity of the narrowing of your esophagus repeat dilations may be required. This allows for dilation to be performed gradually and will decrease the risk of complications. Once the esophagus is completely dilated, repeating treatments may no longer be required. Medicines can reduce the risk of narrowing reoccurring when acid-reflux was the cause.