Oesophageal stricture is narrowing or tightening of the esophagus, (a tube that carries foods and liquids from the mouth to the stomach) which leads to pain and difficulty in swallowing, vomiting, and loss of weight. Some of the factors that can cause narrowing include congenital defects, radiation therapy, sclerotherapy, oesophageal surgery, stomach narrowing, and scar tissue formation. Stricture is relieved by dilatation technique.
Oesophageal dilatation: It is a procedure to widen or clear the blockage in esophagus. It relieves difficulty in swallowing. It is done under local anesthesia. Patient should not take food for 4 to 6 hours before the procedure.
This treatment uses dilators along with an endoscope (a narrow tube with a tiny light and camera at the end). It is inserted through the mouth into the esophagus. Dilators are passed to the blocked site. Endoscope enables viewing the inside of esophagus and dilators pass down the esophagus to increase the size.
Various types of dilators are available for use in oesophageal dilatation.
Simple Dilators (Bougies): These are series of flexible dilators. One or more of these bougies are passed down through the esophagus which helps in opening the esophagus.
Guided wire bougie : During endoscopy, a flexible wire is passed across the stricture. The wire is left in place and endoscope is removed. A small tube that is wider at one end is passed down the esophagus through the stricture. The wire is removed at the end of the procedure. Guided wire bougies are used to treat all kinds of strictures.
Balloon dilators : Deflated balloon is passed through the endoscope across the stricture. The deflated balloon is then inflated which breaks the stricture. It is used to treat achalasia, a rare swallowing disorder of the lower sphincter muscle of the esophagus. A larger balloon type dilator is inserted into the lower esophagus through an endoscope. The muscle fibers are stretched and broken. This procedure helps in easy passage of food into the stomach.
Some of the complications of oesophageal dilatation procedures include perforation, bleeding, and infection. Perforation causes a hole in the lining of esophagus which is surgically repaired.