食管扩张 - 常见问题

Esophageal Dilation - Frequently asked question

                               
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Esophageal Dilation

What's Esophageal Dilation?

Esophageal dilation is really a procedure which allows patient’s physician to dilate, or stretch, a narrowed area of patient’s esophagus. Physician can use various techniques for this procedure. Patient’s physician might perform the process as part of a sedated endoscopy. Alternatively, patient’s physician might use a local anesthetic spray towards the back of patient’s throat and then pass a weighted dilator through the mouth area and into patient’s esophagus.

How should a patient prepare for the process?

An empty stomach enables the very best and most secure evaluation, which means patient should have absolutely nothing to drink, including water, for at least 6 hours prior to the examination. Patient’s physician will explain when he/she should start fasting. Patient should tell doctor ahead of time about any medications he or she is taking, particularly aspirin products or anticoagulants or clopidogrel. Most medicines can be continued as usual, but patient might need to adjust his/her usual dose before the examination. Patient’s physician will give specific guidance. Those who have any allergies to medicines as well as health conditions for example heart or lung disease should tell the physician. Also, inform physician if patient needs antibiotics just before dental procedures, since patient may need antibiotics prior to esophageal dilation too.

Exactly why is Esophageal Dilation Done?

The most typical reason for narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of gastric acid occurring in patients with heartburn. Patients having a narrowed portion of the esophagus often have trouble swallowing; food feels like it is “stuck” in the chest region, causing soreness or pain. Less frequent reasons for esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer from the esophagus, scarring after radiation treatment or perhaps a disorder of the way the esophagus moves.

Will Repeat Dilations be Essential?

With respect to the degree and cause of narrowing of patient’s esophagus, it's quite common to need repeat dilations. This allows the dilation to become performed slowly and decreases the risk of difficulties. When the stricture, or narrowed esophagus, is completely dilated, repeat dilations may not be needed. When the stricture was due to acid reflux, acid-suppressing medications can decrease the chance of stricture recurrence. Patient physician will advise him/her on this.

What are the Potential Complications of Esophageal Dilation?

Although difficulties may appear even when the procedure is performed correctly, they are rare when performed by physicians who are specially trained. A perforation, or hole, of the esophagus lining happens in a small percentage of cases and could need surgery. A tear of the esophagus lining may arise and bleeding may result. There are also probable risks of unwanted effects from sedatives. Patient should identify early signs of possible difficulties. For those who have heart problems, fever, trouble breathing, difficulty swallowing, bleeding or black bowel movements following the test, tell the doctor immediately.

So what can a patient expect during Esophageal Dilation?

Patient’s physician might perform esophageal dilation with sedation together with an upper endoscopy. Patient’s physician may spray in patient’s throat having a local anesthetic spray, and then give him/her sedatives to help relax. Patient’s physician then will pass the endoscope through his/her mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with patient’s breathing. At this point doctor will settle if to use a dilating balloon or plastic dilators on the guiding wire to stretch your esophagus. Patient might encounter gentle pressure in the back of his/her throat or perhaps in chest during the procedure. Alternatively, patient’s physician might start by spraying patient’s throat having a local anesthetic. Patient’s physician will pass a tapered dilating instrument through the mouth area and guide it into the esophagus. Patient’s physician may also use x-rays during the esophageal dilation procedure.

So what can a patient expect after Esophageal Dilation?

Following the dilation is performed, patient will likely be observed for a while of time after which permitted to return to normal activities. Patient may resume drinking once the anesthetic no more causes numbness for his or her throat, unless patient’s physician advices him/her otherwise. Most patients experience no symptoms following this procedure and may resume eating the next day; however, patient might experience a gentle sore throat for that remainder during the day. If patient received sedatives, he or she probably will be monitored inside a recovery area until ready to leave. Patient will not be allowed to drive after the procedure even though he/she may not feel tired. Patient should arrange for anyone to accompany home, because the sedatives might affect judgement and reflexes throughout the day.