If you are experiencing discomfort that feels like you have food lodged in your sternum, you may be experiencing symptoms of an oesophageal stricture. A stricture refers to a narrowed part of your oesophagus and can make actions, such as swallowing, painful.
In this case, the condition can be efficiently treated and corrected with an oesophageal dilation. The standard procedure is highly efficient in relieving strictures and resolving any future pain you may experience when eating or drinking.
What is Oesophageal Dilation?
Your oesophagus (commonly known as a gullet) is the muscular tube that runs down your chest, connecting your throat to your stomach. The primary role of your oesophagus is to pass food and liquid from your mouth into your stomach. However, this may become difficult when the tube narrows.
An oesophageal dilation, also referred to as esophageal dilation, is a procedure that stretches and widens a narrowed section of your oesophagus. The process involves a range of surgical techniques, all of which help expand the width of your oesophagus to relieve discomfort when eating or drinking.
Who Needs Oesophageal Dilation?
If you’re experiencing trouble swallowing, you may need oesophageal dilation. Commonly, this symptom is an indicator of the following problems:
- Peptic stricture: Occurs due to acid reflux (GORD), which damages the lining of your oesophagus and causes a build-up of scar tissue. In return, this narrows the tube, causing irritation when eating, a sore throat and bad breath.
- Schatzki’s ring: The abnormal development of a muscular ring located at the point where your oesophagus and stomach meet. The ring can block food from entering the stomach, causing an accumulation of food at the base of the oesophagus.
- Achalasia: This is where your lower oesophageal sphincter (LOS) permanently tightens, preventing food or liquids from entering the stomach. The LOS is a muscular ring that opens and closes during the process of swallowing, stopping stomach acid from emerging into your oesophagus.
- Eosinophilic esophagitis: The inflammation (swelling) of your oesophagus and is commonly caused by food allergies or other environmental factors.
- Side Effect of Radiation Therapy or Chemotherapy: Cancer treatment can lead to excessive scar tissue building up in the oesophagus, causing strictures. This is mainly for patients receiving radiation treatment for oesophageal cancer.
These conditions are manageable, with oesophageal dilation being the preferred treatment method.
How to Prepare for an Oesophageal Dilatation
If you have been experiencing symptoms which may suggest you have a narrowed oesophagus, you should consult your local doctor. During this appointment, they will refer you to a gastroenterology centre for further examination.
Initial Testing
A gastroenterologist can carry out a range of investigations to determine if you need an oesophageal dilation.
The most common points of investigation include:
- Upper gastrointestinal endoscopy: This involves inserting a long narrow tube equipped with a camera (an endoscope) into your oesophagus via the mouth. This helps the gastroenterologist visualise the narrow section of your oesophagus and identify any other underlying areas of concern. An endoscopy is the preferred method for diagnosis.
- Barium swallow study: Evaluates your ability to pass liquids and food from your oesophagus to your stomach. The study requires you to consume beverages lined with barium, which is a material that is easily identifiable with X-ray imaging. This helps gastroenterologists identify the area, size and location of the stricture present in your oesophagus.
Once a gastroenterologist confirms the need for an oesophageal dilation, they will then provide you with information tailored towards your condition and obtain your consent to complete the procedure.
Fasting
On the day of your oesophageal dilation, ensure that you fast at least 6 hours before the procedure (unless advised otherwise by your gastroenterologist). This is because an empty stomach will allow a clear view of your oesophagus, alongside minimising the risk of complications.
A helpful tip is to try booking your appointment for the morning and avoid eating after midnight. This will allow you to sleep during the fasting period, making it easier to prepare for the procedure.
Medication
You should inform your gastroenterologist if you take any blood thinners, insulin, or other prescription medication. The gastroenterologist will inform you of which medications you should stop taking or, recommend taking a smaller dose in the days prior to the procedure.
You must also let the gastroenterologist know if you have any pre-existing conditions. In particular, if you have a heart or lung disease, you must tell your gastroenterologist as this can hinder the performance of the procedure.
Ultimately, these are critical steps in minimising the risk of complications occurring during the procedure.
Oesophageal Dilation Procedure
Before the procedure, you will be given a local anaesthetic to numb your oesophagus. As a result, you will not feel any pain during the dilation; however, you may experience some slight pressure around your throat and chest region.
If you feel uncomfortable about the invasive nature of the procedure, you can also request a general anaesthetic for sedation.
Following this, an endoscope is passed through your mouth and inserted into your oesophagus. This will allow the performing physician to reassess the area of concern and examine the size of the stricture.
The results from the endoscopy will ultimately guide the physician’s choice of dilatation technique, as there are several methods to treat strictures.
Such methods depend on the size, shape and location of the stricture.
Of these include:
- Balloon dilators: A small balloon is inserted into the narrow section of the oesophagus and carefully filled with air to widen the stricture. Following this, the balloon dilator is slowly deflated and removed from the oesophagus.
- Guided wire dilators: A thin wire is carefully inserted into the oesophagus. Then, a small tube with a widened end is guided down this wire to stretch the narrow oesophageal section.
- Bougies: The technique involves inserting cone-shaped tubes into the oesophagus. Progressively, the size of the tubes increases, steadily stretching and widening the narrow channel.
These straightforward procedure techniques should take no longer than 15 minutes.
While all methods are adequate, the Centre for Gastrointestinal prefers using the balloon dilatation technique due to its effectiveness and simplicity.
Post-Procedure Care
Following your procedure, you will need to stay in a recovery room for 2 hours for observation. During this time, either your physician or medical professional will provide you with information concerning fluid intake, diet change and medication.
After your 2 hour observation period, you can return home provided that you aren’t experiencing trouble breathing or fever. We recommend organising someone to collect you from the hospital, as you should not be operating heavy machinery for at least 12 hours following the completion of the procedure.
What to Expect After Oesophageal Dilation
To avoid any complications, you should ensure to follow your doctor’s orders alongside these general guidelines:
- Avoid operating heavy machinery for 12 hours.
- Avoid alcohol consumption for 12 hours.
- Resume eating and drinking after your throat is no longer numb from the sedative.
- Take 24 hours to rest, return to normal activities and work the day after the procedure.
Oesophageal Dilation Pain
You may experience a mild sore throat and minimal chest pain following your procedure. However, most patients experience no symptoms of discomfort after an oesophageal dilation.
If you are experiencing a sore throat, consider consuming warm liquids and soft foods to aid in your recovery.
Difficulty Swallowing After Oesophageal Dilation
If you are still experiencing throat pain and have difficulty swallowing in the days following your dilation, seek medical attention. Alternatively, if you’re worried about your inability to swallow, contact our friendly staff at 1300 580 239.
Are Oesophageal Dilations Permanent?
Unfortunately, oesophageal dilation can only be used to treat and manage strictures, not cure them. It is not uncommon for stricture recurrence, which may result in you undergoing another dilation procedure.
However, the benefits of dilation outweigh the minimal inconvenience of undergoing the procedure multiple times.
Oesophageal Dilation Benefits
There are a range of benefits that you can enjoy immediately after your oesophageal dilation.
These include:
- Straightforward procedure with a short recovery period, allowing you to return to normal activities within days after dilation.
- Ability to eat and drink on the same day as the procedure.
- Minimal discomfort both during and after the dilation.
- Can enjoy future eating and drinking without any pain caused by a stricture.
Oesophageal Dilation Complications
While uncommon, it is essential to understand that there are possible complications involved with oesophageal dilations.
Like any surgery, there is a risk in administering the anaesthetics. For this reason, it is critical to inform your gastroenterologist of any medications, allergies or preexisting conditions that you have before your procedure.
Another complication is that there is a risk of perforating the oesophagus lining during the procedure. Perforation occurs due to the mishandling of medical instruments and can result in bleeding. If you cough up blood following the procedure, seek medical attention immediately as you may need surgery to correct the error.
Oesophageal Dilation Cost
According to the Medicare Benefits Scheme, the average fee for dilatation of stricture of the upper gastrointestinal tract sits at $348.95.
Furthermore, Medicare can cover up to 85% of the procedure cost.
FAQs
How long does it take to recover from oesophageal dilation?
You can expect to fully recover within 24 hours following your dilation. It is normal to have chest pain or a sore throat after the procedure. However, these symptoms should clear after a day.
What is the success rate of oesophageal dilation?
The success rate for dilation procedures is exceptionally high. Medical studies have found that the balloon dilation of the narrowed area in the oesophagus is 90% successful. Read the study here.
Is it painful to have your oesophagus stretched?
No. Before your procedure a doctor will administer a local anaesthetic to numb your oesophagus. The only symptoms you may feel is a slight pressure in your throat and chest.
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