Oesophageal Stricture Dilatation

What is an oesophageal stricture?

An oesophageal stricture is a narrowing of the oesophagus (the food pipe), which can make swallowing difficult or painful. It may be caused by:

  • Acid reflux or gastro-oesophageal reflux disease (GORD)

  • Eosinophilic oesophagitis (EoE)

  • Oesophageal rings or webs (narrow bands of tissue that narrow the internal diameter of the oesophagus)

  • Scarring from previous endoscopic procedures, surgery, or radiotherapy

  • Severe inflammation from infection, certain medications, or ingestion of caustic substances

Strictures can lead to symptoms such as:

  • Difficulty swallowing (dysphagia)

  • Pain with swallowing (odynophagia)

  • Food getting stuck

  • Unintentional weight loss

What is oesophageal dilatation?

Oesophageal dilatation is a procedure used to gently stretch or widen a narrowed section of the oesophagus to improve swallowing. It is performed during a gastroscopy using either:

  • Balloon dilators: Inflated at the site of narrowing to gradually stretch the stricture.

  • Bougie dilators: Tapered, flexible tubes passed through the stricture (over a guide wire) to stretch the narrowing .

Dilatation may need to be repeated over time, depending on the underlying cause and the severity of the narrowing.

Is it painful?

The procedure is usually performed under sedation to ensure you are comfortable and unaware during the procedure. You may experience mild discomfort, a sore throat, or bloating afterwards—this generally settles within a few hours. Severe pain is uncommon; if it occurs, please seek medical attention.

What is the preparation?

The preparation is the same as for a standard gastroscopy:

  • Fast for at least 6 hours before the procedure. You may take small sips of water up to 2 hours beforehand.

  • Let Dr Clark-Dickson know if you take blood-thinning medications (e.g. aspirin, clopidogrel, ticagrelor, warfarin, apixaban, rivaroxaban, or dabigatran), as these may need to be temporarily adjusted to reduce the risk of bleeding.

What are the risks?

Oesophageal dilatation is generally safe, but like all procedures, it carries some risks:

  • Sore throat or chest discomfort (common, usually mild)

  • Bleeding (rare)

  • Perforation (a small tear in the oesophagus), which occurs in 0.5% to 2% of cases—this is uncommon but may require hospitalisation or repeat procedures, including surgery

What happens after the procedure?

After the procedure:

  • You will be taken to recovery until the sedation wears off.

  • Once awake, I will discuss the findings with you and provide a written report.

  • You will be kept nil by mouth for 4 hours, followed by clear fluids overnight. The next morning, you can begin with soft foods and liquids for 24 hours.

If biopsies were taken or the dilatation was performed as part of treatment for another condition, I will follow up with results via a clinic appointment or phone call.

When should I seek help?

Please seek urgent medical attention if you experience:

  • Severe chest pain or difficulty breathing

  • Vomiting (especially if it contains blood or dark-coloured material)

  • High fever or chills

  • Increased difficulty or pain with swallowing