The esophagus is a muscular tube responsible for transporting food and liquids from the throat to the stomach. It contracts and expands to facilitate food passage. Under certain circumstances, the esophagus can become narrowed, which can interfere with its normal function. Medical procedures are available to stretch the esophagus and restore its proper width.
Causes of Esophageal Narrowing
Several medical conditions can lead to a narrowed esophagus, often requiring intervention. Benign esophageal strictures commonly develop from scar tissue due to chronic irritation. Gastroesophageal reflux disease (GERD), where stomach acid repeatedly flows back into the esophagus, is a frequent cause of this scarring and inflammation. Injury or other chronic inflammation can also contribute to stricture formation.
Another condition, achalasia, results from the lower esophageal sphincter failing to relax properly. This muscular ring at the junction of the esophagus and stomach fails to open adequately, preventing food and liquid from passing into the stomach. Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease where white blood cells called eosinophils accumulate in the esophageal lining. This buildup can lead to inflammation, scar tissue, and subsequent narrowing and swallowing difficulty.
The Esophageal Dilation Procedure
Esophageal dilation is typically an outpatient procedure performed under sedation. An endoscope, a thin, flexible tube with a camera, is guided through the mouth into the esophagus to visualize the narrowed area.
Two primary methods are used to stretch the esophagus. Bougie dilators are progressively larger, flexible tubes passed over a guidewire through the narrowed section. Alternatively, balloon dilators use a deflated balloon inserted through the endoscope to the constricted area. The balloon is then inflated with air or water to stretch the esophageal walls to a predetermined size. The procedure usually takes about 15 minutes, and patients might experience mild pressure or a sore throat immediately afterward.
Post-Procedure Expectations and Outcomes
Patients typically recover briefly before being discharged home the same day. Common sensations include a mild sore throat or chest discomfort, which usually subsides within a day or two. Most individuals can resume drinking fluids once throat numbness wears off and often return to a soft diet within hours or the next day.
The primary goal of dilation is to improve swallowing difficulties. However, esophageal narrowing can recur, particularly if the underlying cause is ongoing. Many patients may require additional dilation procedures over time to maintain symptom relief. Regular follow-up with a healthcare provider is important to monitor progress and determine if further treatment is needed.
Risks and Safety Information
While generally considered safe, esophageal dilation carries some potential risks. The most significant, though uncommon, complication is perforation, a tear or hole in the esophageal wall. This occurs in about 1 to 4 out of 1,000 dilations. If a perforation occurs, it may require immediate medical or surgical intervention.
Minor bleeding at the site of dilation is also possible. There is a risk of infection if bacteria enter the bloodstream during the procedure, potentially leading to bacteremia. Additionally, general risks associated with sedation, such as adverse reactions, exist. Patients should seek immediate medical attention if they experience severe chest pain, difficulty breathing, fever, or vomiting blood after the procedure.