How Esophageal Dilation Helps Difficulty Swallowing

Esophageal dilation is a treatment to help stretch, or dilate, abnormal narrowings found in the esophagus. These narrowings are called strictures and can occur from a variety of health problems.

Your healthcare provider will likely send you to either an otolaryngologist (ear, nose and throat doctor) or, more likely, a gastroenterologist (stomach and bowel disorder doctor) in order to have this procedure performed.

Methods of Esophageal Dilation

There are three different methods used to perform esophageal dilation:

  • Weighted bougie: A push type dilator that is either mercury-filled (Maloney) or tungsten-filled (Hurst)
  • Wire-guided dilator: A guide-wire is inserted first and then a polyvinyl dilator (Savary-Gilliard or American) is inserted over the guide-wire
  • Balloon dilator: Inserted to the point of the stricture, under endoscopy (using a video endoscope) or fluoroscopy (using X-ray), and then inflating the balloon
Human Digestive System Anatomy (Stomach)
magicmine / Getty Images

Why Is Esophageal Dilation Performed?

Over time, different health problems can cause strictures to form in the esophagus, causing a narrowing of the esophagus. These strictures can make it difficult to swallow and you may have a feeling of food getting stuck in your chest. This feeling is because the food has a difficult time moving past the stricture.

In most cases, these strictures are a result of the accumulation of fibrous or collagen tissue accumulation. Here is a list of disorders that may benefit from using esophageal dilation:

Esophageal dilation is not a cure for any of the disorders above and the symptoms will likely recur in time. However, esophageal dilation can be a useful method in relieving symptoms.

Associated Risks

You should only have esophageal dilation performed by a trained care provider. While esophageal dilation is generally a safe procedure, there are some risks that you should be aware of.

Even though the risks sound scary, esophageal dilation, in general, is safe to perform in an outpatient setting and does not need to be performed in a hospital.

Bleeding and aspiration can occur with almost any procedure involving the airway or esophagus. Your healthcare provider will watch for these complications throughout the procedure. You should seek medical attention if you notice any of the following after the esophageal dilation:

  • Difficulty breathing
  • Fever
  • Chest pain
  • Bloody or black bowel movements

The most dangerous complication is the risk for perforation, or a hole in the esophagus. This can occur in approximately one to four out of 1,000 dilations. If a perforation occurs, surgery may be required immediately.

Your risk may be higher for perforation if your stricture is related to radiation therapy. Your risk is also higher if you have a healthcare provider that hasn’t performed the surgery frequently.

What to Expect

Prior to the esophageal dilation, you will need to fast (not have food or water) for a minimum of six hours. You should follow your healthcare provider’s pre-procedure instructions regarding fasting time.

If you are on any medications that thin your blood (aspirin, warfarin, etc.) you should notify your healthcare provider. You may not need to be taken off the medication. However, your healthcare provider may choose to adjust your dose or take extra precautions. Not telling your healthcare provider about these medications may increase your risk of having a bleeding complication.

You may also be prescribed antibiotics prior to the procedure if you have a history of certain heart diseases. If you take antibiotics with dental work, you should make sure to discuss antibiotics with your healthcare provider.

During the procedure, your healthcare provider may use sedation in order to help you relax and not remember the procedure. If this method is used, you will need someone to drive you home, as common medications used in this procedure include fentanyl, versed, and propofol. All these medications require that you do not drive for 24 hours.

Alternatively, your healthcare provider may use a spray anesthetic to numb your throat to perform your procedure. If this method is used, you will be fully awake for the procedure and would be able to drive.

Many people, however, prefer to use sedation, because the thought of a long tube being inserted into your throat down to your stomach can be scary, particularly if you are prone to claustrophobia.

After the procedure, you will be given instructions on when you can eat and drink. Drinking will be withheld until any anesthetic effects have worn off. This is so that you do not have liquid go into your lungs instead of your stomach, since the anesthetic inhibits the normal swallowing functions.

You will likely also have a mild sore throat for several days after the procedure.

Will I Need Esophageal Dilation Again?

It is common for symptoms to eventually return after an esophageal dilation. How long it takes for symptoms to recur is variable and dependent on many factors including the severity and cause of the stricture.

In many cases, dietary management, use of proton pump inhibitors (PPIs), and other medical therapies can help delay if not prevent the need for future esophageal dilations. Working closely with your healthcare provider and following your individualized treatment plan can help keep symptoms under control for longer periods of time.

Esophageal dilation is a treatment and not a cure. However, symptom relief makes this procedure very useful to improve your quality of life.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. American Society for Gastrointestinal Endoscopy. Understanding esophageal dilation.

  3. American College of Gastroenterology. Dysphagia: Causes.

  4. Dougherty M, Runge TM, Eluri S, Dellon ES. Esophageal dilation with either bougie or balloon technique as a treatment for eosinophilic esophagitis: a systematic review and meta-analysis. Gastrointest Endosc. 2017;86(4):581-591.e3. doi:10.1016/j.gie.2017.04.028

  5. Agarwalla A, Small AJ, Mendelson AH, Scott FI, Kochman ML. Risk of recurrent or refractory strictures and outcome of endoscopic dilation for radiation-induced esophageal strictures. Surg Endosc. 2015;29(7):1903-12. doi:10.1007/s00464-014-3883-1

  6. Runge TM, Eluri S, Woosley JT, Shaheen NJ, Dellon ES. Control of inflammation decreases the need for subsequent esophageal dilation in patients with eosinophilic esophagitis. Dis Esophagus. 2017;30(7):1-7. doi:10.1093/dote/dox042

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.