Esophageal stretching, or dilation, widens a constricted portion of the esophagus, the tube connecting the throat to the stomach. This procedure eases the passage of food and liquids, addressing difficulty swallowing or a sensation of food being lodged in the chest. It is a common outpatient procedure to improve eating and drinking comfort.
Medical Conditions Leading to Esophageal Stretching
The primary reason for esophageal stretching is strictures, narrowed areas within the esophagus. Gastroesophageal reflux disease (GERD) is a frequent cause, where stomach acid repeatedly flows back into the esophagus, leading to inflammation and scar tissue that tightens the passage. These are often referred to as peptic strictures.
Another condition necessitating dilation is eosinophilic esophagitis, an allergic inflammatory response in the esophagus often triggered by certain foods. This inflammation can cause swelling and narrowing. Radiation therapy to the chest or neck, used for cancer treatment, can also induce scarring and stricture formation.
Prior surgeries on the esophagus, injuries from swallowing corrosive substances like household cleaners, or long-term use of nasogastric tubes can result in scar tissue that restricts the esophageal opening. Less common causes include achalasia, which impacts the muscle at the lower end of the esophagus, preventing it from relaxing, and Schatzki’s rings, abnormal tissue rings at the junction of the esophagus and stomach.
Understanding Esophageal Dilation
Esophageal dilation is an outpatient procedure, often in an endoscopy department. Before the procedure, individuals fast for several hours, at least six, to ensure an empty stomach. This allows for a clear view and helps minimize risks. Patients receive sedation to help them relax and may have a local anesthetic spray applied to the throat to numb the area.
During the procedure, a gastroenterologist uses an endoscope, a thin, flexible tube with a light and camera, guided through the mouth and into the esophagus. This allows the physician to visualize the narrowed area directly. Different methods exist for dilation.
One common technique involves passing a deflated balloon through the endoscope to the narrowed segment and inflating it with air or water to gently stretch the esophagus. Another method uses bougies, a series of progressively larger, cone-shaped plastic tubes passed over a guidewire to gradually widen the stricture. The choice of method depends on the stricture’s specific characteristics. The dilation process usually takes about 15 minutes.
Post-Procedure Care and Expectations
Following esophageal dilation, patients are monitored in a recovery area for a short period, generally 30 minutes to a few hours, while sedation wears off. Mild discomfort, such as a sore throat or pain behind the breastbone, is common and usually subsides within a few days. Over-the-counter pain relievers can help manage this discomfort.
Dietary adjustments are recommended immediately after the procedure. Individuals consume clear liquids initially, progressing to soft foods like yogurt or mashed potatoes before gradually returning to their regular diet, often within 24 hours. Chewing food thoroughly and taking small bites are important practices.
Patients should contact their healthcare provider if they experience concerning symptoms such as fever, severe chest pain, difficulty breathing, vomiting blood, or black, tarry stools, as these could indicate a need for medical attention. While many find relief after one dilation, some conditions may require repeat procedures to maintain the esophageal opening, especially if the underlying cause, such as GERD, is chronic.