Upper Endoscopy (EGD) with Esophageal Dilation
This procedure allows your doctor to dilate (stretch) a narrowed area of your esophagus. It is performed as part of an Upper Endoscopy (EGD).
Why is it done?
The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of acid occurring in patients with heartburn. Patients with a narrowed portion of the esophagus often have trouble swallowing; food feels like it is “stuck” in the chest region, causing discomfort or pain. Less common causes of esophageal narrowing are webs or rings (which are caused by thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves (known as motility disorder).
How should I prepare for the procedure?
An empty stomach allows for the best and safest examination, so you should have nothing to drink (including water) for at least six hours before the examination. Your doctor will tell you when to start fasting.
Tell your doctor in advance about any medications you take, particularly aspirin products or anticoagulants (blood thinners). Most medications can be continued as usual, but you might need to adjust your usual dose before the examination. Your doctor will give you specific guidance. Tell your doctor if you have any allergies to medications as well as medical conditions such as heart or lung disease. Also tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to esophageal dilation as well.
What can I expect during esophageal dilation?
Your doctor might perform esophageal dilation with sedation along with an upper endoscopy. Your doctor may spray your throat with a local anesthetic spray, and then give you sedatives to help you relax. Your doctor then will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing. At this point your doctor will determine what technique they will use to stretch your esophagus.
What techniques may be used?
There are various techniques that your doctor can use to perform an esophageal dilation. One common technique for dilation uses a small weighted tool that passes through your mouth and into your esophagus. Another technique used often utilizes a small balloon that is inflated in the esophagus via an endoscope.
What can I expect after esophageal dilation?
The sedatives used might affect your judgment and reflexes for the rest of the day. Therefore, you will not be allowed to drive after the procedure and should arrange for someone to accompany you home.
You may resume drinking when the anesthetic no longer causes numbness to your throat, unless your doctor instructs you otherwise. Most patients experience no symptoms after this procedure and can resume normal activities such as eating the next day, but you might experience a mild sore throat for the remainder of the day.
What are the potential complications of esophageal dilation?
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 hole, of the esophagus lining occurs in a small percentage of cases and may require surgery. A tear of the esophagus lining may occur and bleeding may result. Complications from heart or lung diseases are potential risks if sedatives were used.
It is important to recognize early signs of possible complications. If you have chest pain, fever, difficulty swallowing, bleeding or black bowel movements after the test, tell your doctor immediately.
Will repeat dilations be necessary?
Depending on the degree of narrowing of your esophagus and its cause, it is common to require repeat dilations. This allows the dilation to be performed gradually and decreases the risks of the procedure. Once the stricture (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.