Will I Need More than One Esophageal Dilatation?

Have you ever felt like something is stuck in your throat and that swallowing has become more difficult? Well, this is a condition that affects a lot of individuals and is known as esophageal strictures. 

It is a condition that results in abnormal narrowing of the esophagus due to a number of causes, like chronic GERD, esophageal scarring, inflammation, injury and other growths. 

One of the common and effective procedures for this condition is esophgeal dilatation that gently stretches the constricted portion of the esophagus. 

But a question that most patients ask is, “Will I get permanent relief in one single session?” The answer is not straightforward. 

In this blog, we will discuss whether a single treatment is enough and, if not, when you need more than one dilatation. 

Esophageal dilatation: An overview 

Esophageal dilatation is a procedure that is used to widen a narrowed section of the esophagus. The goal is to allow foods and liquids to pass through the esophagus more swiftly, thereby making swallowing easier. In the medical context, it is a therapeutic endoscopic procedure that enlarges the lumen of the esophagus. 

There are three common techniques used:

1. Balloon Dilators – Inflated inside the narrowed area using a catheter to stretch the narrowed passage.
2. Bougie Dilators – Thin and flexible tubes are passed through the stricture.
3. Guided Wire Dilatation – A wire guides the dilator, like a balloon or bougie, to the exact location.

Patients are sedated during the procedure, and it’s generally performed on an outpatient basis.

How many sessions are typically required? 

The number of esophageal dilatation sessions an individual requires depends on the severity of the condition. 

Many patients with a mild, first-time stricture may only need one dilatation, especially if the underlying cause is addressed. However, for more persistent and moderate strictures, 2- 4 sessions are required, performed over several weeks and months. 

Moreover, there are cases when some patients suffer from chronic and complex strictures that might require periodic dilatation to prevent narrowing of the esophagus. 

When do you require multiple esophageal dilatations? 

While patients experience immediate relief following one session, others might require multiple treatments under the following circumstances. 

1. Severity of the stricture 

Patients with mild strictures caused by acid reflux often respond well to a single session. However, the complex ones caused by radiation, injury, or post-surgical changes often require gradual widening over multiple procedures to avoid tearing or complications.

2. Underlying cause of the narrowing 

If the stricture is due to chronic GERD or conditions like esophagitis, the narrowing often recurs. Such individuals require multiple dilatations unless the underlying cause is treated. 

3. Esophageal Scarring or Fibrosis

Strictures which have developed scar tissue tend to be more rigid and resistant to stretching. As a result, patients require multiple and gradual dilatations to achieve the desired result. 

Are there any risks involved in multiple dilatations? 

Repeated dilatation is considered to be safe, especially when performed by an experienced gastroenterologist. However, risks slightly increase with more than one session and include. 

1. Excessive bleeding 
2. Perforation (tear in the esophagus)
3. Infection 
4. Temporary chest discomfort and pain 
5. Allergic reaction to anesthesia 

What should you expect soon after the procedure? 

Following esophageal dilatation, patients experience these symptoms 

• Mild soreness or scratchiness for a few days. 
• A feeling of fullness or bloating
• Fatigue from anesthesia 

You will be asked to stick to a liquid diet for some days. Most people can return to soft foods within 24 hours. In case you experience symptoms like severe chest pain, fever, vomiting, difficulty breathing, or trouble swallowing, contact your healthcare provider immediately. 

Conclusion 

More than one esophageal session is not uncommon. If you need to undergo esophageal dilatation, speak to your gastroenterologist about the procedure. With proper treatment and follow-up, it is possible to get lasting relief.