Esophageal Dilatation

WHAT YOU SHOULD KNOW:

• Esophageal dilatation is a procedure to widen the part of your esophagus that is too narrow. The esophagus is the soft tube that carries food and liquids from your throat to your stomach. Any injury or change in the esophagus tissue may cause it to have swelling and damage. When damaged areas heal, scar tissue can form to make the areas hard and stiff. Areas of scar tissue can cause the esophagus to become narrow. Food, and sometimes liquids, may have a hard time passing through the narrow part of the esophagus. Injuries may be caused by long-standing reflux disease, infections, surgery, radiation treatment, or swallowing chemicals or foreign bodies. A tumor (growth) inside or near the esophagus, and diseases of the esophageal muscles may also cause narrowing.
  
  
• An endoscopy exam of the esophagus and stomach (EGD) may be done before or during the dilatation procedure. This is done with an endoscope, which is a bendable tube that has a light and camera on its end. Esophageal dilatation is done using one of three types of dilators. A balloon dilator may be passed through the endoscope during the exam and then inflated in the esophagus. A rigid or bougie dilator is passed through your mouth without the endoscope until it reaches the narrowing. Bougies are dilators made of soft rubber and filled with metal to make them heavy. Rigid dilators are made of hard plastic and positioned using a guide wire passed through the endoscope. Your caregiver may use fluoroscopy (special type of x-ray) to guide him during the procedure. Usually no more than three dilators of increasing sizes are passed in a single procedure. Having an esophageal dilatation will help relieve your problems with swallowing food.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may get too much sedation or have an allergic reaction to the medicine. This may cause you to have trouble breathing. Some of your saliva or stomach fluids may get into your lungs and cause pneumonia. Your esophagus may get damaged from the procedure, and cause infection or bleeding. If you have a large injury or too much bleeding, you may need surgery to fix it. Even with a successful procedure, your esophagus may again get narrow. This may mean having the procedure done again or repeated many times, or you may need surgery. Call your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Medicines: You may receive any of the following medicines before your endoscopy or dilatation:
  
  
  • Antibiotic: You may be given an antibiotic medicine if you are at risk for getting an infection from your procedure.
    
    
  • Local anesthesia: This is a numbing medicine that may be sprayed in your throat before your procedure.
    
    
  • Conscious sedation: This is medicine that will make you mildly sedated. This medicine will help to keep you from having discomfort and gagging during the procedure.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

During your procedure:

• You will be taken to an endoscopy room. Oxygen may be given through a nasal cannula (a pair of short, thin tubes resting inside your nose). You will seat in a chair or lie down on your left side on a special table. Your caregiver will place a plastic guard in your mouth to protect your teeth. When you become sleepy from the sedation, endoscopy may be done before or while doing the procedure. The endoscope or dilator is passed through your mouth down into the narrowed part of your esophagus. A biopsy (tissue sample) may be taken and sent to lab for tests before the dilatation. Fluoroscopy may be done to check if the dilator or guide wire is in the right place.
  
  
• Dilatation is done with the dilator or balloon in place for 1 to 2 minutes. This may be repeated once or twice with larger dilators. The endoscope may be inserted again to place a stent (tube to hold the esophagus open). A shot of steroid medicine may also be given to help prevent the area from getting narrow again. The dilator and scope are removed carefully. A chest or contrast x-ray may be done to check for tears.

After your procedure:

You may lie in bed and rest while you wake up from the sedation. Caregivers will continue to monitor your vital signs. You may be allowed to drink water after your procedure. When your caregiver sees that you are OK, you are allowed to change clothes and go home. If your caregiver wants you to stay in the hospital, you will be brought to your hospital room.

Learn more about Esophageal Dilatation (Inpatient Care)