Esophageal dilation is a procedure that allows your doctor to stretch (or dilate) a narrowed area of your esophagus. Your doctor may perform the procedure as part of an upper endoscopy, while you are mildly sedated. Or your physician may apply a local anesthetic spray to the back of your throat and then pass a weighted dilator through your mouth and into your esophagus.
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The most common cause of narrowing of the esophagus (also called stricture), is scarring of the esophagus from reflux of stomach acid in patients with heartburn. Patients with a narrowed portion of the esophagus may have trouble swallowing or it feels like food is “stuck” in the chest region. Less common causes of esophageal narrowing include thin layers of excess tissue, cancer of the esophagus, scarring after radiation treatments or a disorder in the way the esophagus moves.
An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink for at least 6 hours before the examination. Your doctor will tell you when to start fasting. See the next section regarding medications, health conditions and allergic reactions for important information your doctor needs to know.
Tell your doctor in advance about any medications you take, especially aspirin products or blood thinners such as Plavix, Coumadin (warfarin) or heparin. You will probably be able to continue with most medicines, but you might need to adjust your usual dose before the procedure.
Also alert your healthcare provider if you have any allergies to medications and if you have major health conditions including heart or lung disease. Let your physician know if you require antibiotics prior to dental procedures, because you may need them prior to esophageal dilation.
Your doctor might perform esophageal dilation along with an upper endoscopy (also called an EGD). Your doctor may spray your throat with a local anesthetic spray and/or give you a sedative to help you relax. He or she will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope is a thin lighted flexible tube and does not interfere with your breathing.
At this point your doctor will determine whether to use a dilating balloon or plastic dilators over a guiding wire to stretch your esophagus. You might experience mild pressure in the back of your throat or in your chest during the procedure.
In some cases, your physician may use a procedure that doesn’t involve an upper endoscopy. He or she is likely to spray your throat with a local anesthetic. Your doctor will then pass a tapered dilating instrument through your mouth and guide it into the esophagus. Your doctor may also use X-rays during the esophageal dilation procedure.
You will be observed until most of the effects of the medications (sedative and/or local anesthetic) have worn off. You may resume drinking when the anesthetic no longer causes numbness to your throat, unless your doctor states otherwise. Most patients experience no symptoms after this procedure and can resume eating the next day. You may experience a slight sore throat for the rest of the day.
If you received sedatives, you will not be allowed to drive, so please arrange for a competent driver to accompany you to this procedure.
Depending on the degree and cause of narrowing of your esophagus, it is common to require repeat dilations. This allows the dilation to be performed gradually and decreases the risk of complications. Once the stricture, or narrowed esophagus, is completely dilated, repeat dilations may not be required. If the stricture was due to acid reflux, acid-suppressing medicines can decrease the risk of stricture recurrence. Your doctor will advise you on this.
Although complications can occur even when the procedure is performed correctly, they are rare when performed by doctors who are specially trained. A perforation, or tear, in the esophagus that causes bleeding occurs in a small percentage of patients – this may require surgery to repair. Some patients, especially those with heart or lung disease, may experience complications from the sedative.
If you have chest pain, fever, trouble breathing, difficulty swallowing, bleeding, or black or tarry bowel movements after the test, call our office immediately.