Endoscopic dilatation

Definition: Endoscopic dilatation is a procedure used to widen a narrowed area (stricture) in the digestive tract. The procedure involves inserting a balloon or other dilating instrument through an endoscope to stretch the stricture and improve the passage of food and liquids.

Causes: Strictures can develop due to:

1. Chronic Acid Reflux (GERD): Leading to esophageal strictures.
2. Scarring from Surgery or Radiation: In the GI tract.
3. Inflammatory Conditions: Such as Crohn’s disease or ulcerative colitis.
4. Swallowing Caustic Substances: Leading to scarring and narrowing of the esophagus.
5. Tumors: That obstruct the GI tract.

Symptoms: Symptoms of a stricture include:

• Difficulty swallowing (dysphagia).
• Pain when swallowing.
• Regurgitation of food.
• Weight loss.
• Nausea or vomiting.

Diagnosing:

1. Endoscopy: Visualizing the stricture directly with an endoscope.
2. Imaging Tests: Barium swallow, CT scan, or MRI to assess the extent and location of the stricture.
3. Biopsy: To rule out malignancy if the stricture is suspicious.

Treatment Options:

1. Balloon Dilatation: A balloon is inflated at the site of the stricture to widen it.
2. Bougie Dilatation: A series of increasingly larger tubes (bougies) are passed through the stricture to stretch it.
3. Stent Placement: A stent may be placed to keep the stricture open, especially in cases where it tends to recur.
4. Surgical Intervention: In severe cases, surgery may be necessary to remove the stricture.

Prevention Tips:

1. Treat Underlying Conditions: Effective management of GERD, Crohn’s disease, and other causes of strictures.
2. Avoid Caustic Substances: Taking care to avoid ingesting harmful chemicals or substances.
3. Regular Monitoring: For patients with known conditions that may cause strictures.

Conclusion: Endoscopic dilatation is an effective, minimally invasive procedure for relieving symptoms caused by strictures in the GI tract. With appropriate treatment and regular follow-up, patients can experience significant relief and improved quality of life.