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What is an esophageal dilation?

Esophageal dilation is the technique of stretching the esophagus and is used to treat difficulty swallowing caused by strictures or rings. Most patients with acid reflux do not need dilation. It is done at the time of endoscopy while patients are sedated. Several different kinds of dilators and different tools are used for different jobs. Your doctor will choose the appropriate dilator based on the location of the narrowing, its length, how tight it is, and experience. We discuss only two kinds of dilators here.

The most commonly used dilator, which has been around for decades and the easiest to use is called a Maloney dilator. It is a long metal-weighted solid plastic tube with a tapered end and is reusable after sterilization. The Maloney dilator comes in various sizes to allow dilation of different kinds of narrowing of the esophagus. Usually, after the esophagus is examined with the endoscope a dilator is passed. This means that a very large hose-like object is swallowed to stretch the stricture. Sometimes multiple dilators need to be passed to ensure that the stricture or ring is adequately dilated. This dilator causes a controlled tear in the esophageal stricture. Although this sounds a like a medieval process, most patients do not remember it, it is not that uncomfortable, and is safe and effective in experienced hands.

Another type of dilator is a balloon dilator. This is literally a balloon on the end of a long thin tube that goes down the endoscope. Once the scope is positioned in the esophagus above the stricture, the balloon is advanced out of the scope and inflated, usually with water. There are different-sized balloons, and even single balloons can be inflated to different sizes based on need and how much pressure is injected into the balloon. The end result is the same as that of the Maloney dilator, a controlled tear in the stricture or ring is created.

Esophageal dilation is a very common procedure and is very safe. The risks are bleeding and perforation, or tearing a hole through the wall of the esophagus. Rarely—about 1 in 1,000 patients—can this happen. If this does occur, patients are hospitalized and generally undergo barium tests or a CAT scan to confirm the diagnosis. A surgeon sees the patient because surgery could be needed to repair the defect in the esophagus. Esophageal perforation is thankfully rare but is serious when it does occur, and a quick diagnosis is required. Esophageal bleeding after dilation is rare and could require hospitalization or a blood transfusion

What is an esophageal dilation? References

By Mortin - Copyright 2009
Last modification 31/12/2009