Esophageal Dilation
Esophageal dilation is an outpatient procedure that stretches your esophagus to make swallowing easier. Healthcare providers use it to treat conditions like esophageal strictures and achalasia. Esophageal stretching has a high success rate, but you might need more than one session to achieve desired results.
Esophageal dilation (eh-sof-uh-JEE-uhl di-LAY-shun) is a procedure that stretches (dilates) your esophagus (swallowing tube) so food can pass through easier.
You might need esophageal dilation if you have symptoms like:
- Difficulty swallowing.
- Feeling like something’s stuck in your throat or chest.
- Painful swallowing.
- Regurgitation (when food from your stomach comes back up into your throat or mouth).
One procedure may be enough to solve the issue, but it’s common to need multiple dilations. How many treatments you need depends on the severity of your condition.
There are a lot of alternate names for esophageal dilation, including “esophageal dilatation” and “esophagus stretching surgery.” Some people may even call it throat stretching surgery. But this isn’t entirely accurate because a healthcare provider stretches your esophagus, not your throat.
Healthcare providers use this procedure to treat esophageal conditions like:
- Esophageal strictures. Strictures are areas of scarring that cause your esophagus to narrow. Chronic acid reflux causes them. Strictures are the most common reason why people need esophageal dilation.
- Achalasia. With achalasia, foods and liquids don’t move from your esophagus and into your stomach like they should. Achalasia affects your lower esophageal sphincter (a ring of muscles that prevents swallowed food from coming back up into your esophagus).
- Esophageal rings. These are scar tissue rings that cause narrowing in your esophagus.
- Eosinophilic esophagitis. Inflammation causes white blood cells to gather in your esophagus. This can result in rings, which cause food to move slowly or get stuck.
Before your procedure, your healthcare provider will review your medical history and ask about any recent illnesses. Be sure to tell them about any medications you take. This includes prescription and over-the-counter (OTC) medications, as well as vitamins and supplements.
You’ll also need to have an empty stomach. Your healthcare provider will give you a list of presurgical instructions, including when to stop eating and drinking the night before. Be sure to follow these guidelines closely.
Healthcare providers use various methods for esophageal dilation. Each uses a slightly different device, but the approach is generally the same:
- A healthcare provider gives you anesthesia to numb your throat and esophagus. They may also give you sedative medications to help you relax.
- Next, a gastroenterologist places an endoscope in your mouth, down your throat and into your esophagus.
- They’ll insert a deflated balloon down to the narrowed portion of your esophagus and fill the balloon with water or air. This gently stretches and widens your esophagus. Or they might use a guide wire and a series of thin plastic tubes (called bougies) to stretch your entire esophagus if there are multiple narrowed areas.
- Once your provider stretches your esophagus to the desired width, they’ll gently remove the balloon (or the bougie).
- Your healthcare provider will keep a close eye on you and let you know when it’s safe to go home. Most people can go home the same day.
Balloon dilation is the most common approach for stretching your esophagus. But healthcare providers may use bougie dilation to treat multiple strictures. If you have an unresponsive esophagus, or severe esophageal strictures, your provider might recommend multiple procedures to stretch your esophagus to a bigger size each time.
Esophageal dilation is an outpatient procedure. It usually takes about 15 minutes to complete.
Esophageal dilation can give you fast relief from swallowing issues. While you might need a repeat procedure in the future, relief usually lasts for months (or sometimes years). Some people will never need another dilation.
Esophageal dilation is a relatively safe, low-risk procedure. It can successfully treat more than 90% of all esophageal strictures.
Complications are rare, but may include:
- Excessive bleeding.
- Perforation (hole) in your esophagus.
- Reactions to anesthesia.
Most people can resume normal routines the day after the procedure.
Esophageal dilation is minimally invasive. But you might still develop uncomfortable side effects like soreness in your throat or behind your breastbone.
These side effects are normal and should go away in a few days. It’s a good idea to have some softer foods on hand, like gelatin, pudding, yogurt and mashed potatoes. Your healthcare provider will also tell you if you need to be on a liquid or soft food eating plan after the dilation.
When should I call my healthcare provider?
Tell your healthcare provider whenever you feel like something isn’t quite right. Let them know if you notice:
- Blood in your poop or black, tarry poop.
- Chest pain.
- Fever of 103 degrees Fahrenheit (39.4 degrees Celsius) or higher.
- Trouble breathing.
- Vomiting blood.
References
- Desai JP, Moustarah F. Esophageal Stricture (https://pubmed.ncbi.nlm.nih.gov/31194366/). 2023 May 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Accessed 10/28/2024.
- Hurtte E, Young J, Gyawali CP. Dysphagia (https://pubmed.ncbi.nlm.nih.gov/37516505/). Prim Care. 2023 Sep;50(3):325-338. Accessed 10/28/2024.
- Nguyen ATN, Baum AL, Valentine MJ, McNab CR, Vollin L, Kirila CE. Esophageal Dilation: A Cross-Sectional Analysis of Patient Information (https://pubmed.ncbi.nlm.nih.gov/38021753/). Cureus. 2023 Oct 15;15(10):e47080. Accessed 10/28/2024.
- Shahein AR, Krasaelap A, Ng K, et al. Esophageal Dilation in Children: A State of the Art Review (https://pubmed.ncbi.nlm.nih.gov/36122370/). J Pediatr Gastroenterol Nutr. 2023 Jan 1;76(1):1-8. Accessed 10/28/2024.
- van Boeckel PG, Siersema PD. Refractory esophageal strictures: what to do when dilation fails (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4328110/). Curr Treat Options Gastroenterol. 2015 Mar;13(1):47-58. Accessed 10/28/2024.
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