Overview

This information is about having an oesophageal dilatation or oesophageal stent procedure for swallowing problems.

The food pipe (oesophagus) is the tube that takes food from your mouth to the stomach. If this tube becomes narrowed or blocked, there will be a problem with swallowing. The procedure is intended to stretch the narrowing of your food pipe and make it easier to swallow.

The aim of this information is to help answer some of your questions about having an oesophageal dilatation or stent. It explains:

• the benefits of the procedure 
• the risks of the procedure 
• how to prepare for the procedure 
• what happens during the procedure 
• what happens after the procedure 

If you have any more questions or concerns, please speak to a doctor or nurse caring for you in the interventional radiology (IR) department.

About oesophageal dilatation

Oesophageal dilatation is a procedure to widen a part of your food pipe that is too narrow. We do this using a long, thin tube called a catheter with a balloon attached.

The procedure should expand the narrow area and make it easier for you to swallow.

About an oesophageal stent

Sometimes, oesophageal dilatation does not resolve swallowing problems. An interventional radiologist (IR doctor) uses imaging machines to diagnose and treat illnesses. They may put a stent in the narrow area.

An oesophageal stent is a metal mesh tube covered in fabric. The IR doctor puts the stent into your food pipe and across the blockage.

The stent passes through your mouth into the food pipe. It is positioned across the area that has become too narrow. The stent then gently expands to allow fluid and food to pass down to the stomach more easily.

Benefits of the procedure

An oesophageal dilatation or stent procedure should:

• expand the area of your food pipe that has become too narrow
• make it easier for you to swallow

Risks of the procedure

It is very rare to have any serious complications from an oesophageal dilatation or stent procedure. However, as with any procedure, there are some risks involved. 

The IR doctor explains the risks before you sign a consent form agreeing to have the procedure.

• There is a small risk of a tear (perforation) of your food pipe. The risk is greater if you currently have high-dose chemotherapy or radiotherapy. This is a serious complication and we may need to do more surgery or put in another stent.
• There is a risk of infection or a small amount of bleeding during the procedure. We can treat infections with antibiotics and bleeding with a blood transfusion (when we give you blood from someone else).
• Some people get heartburn and acid reflux after the procedure. This is a burning feeling in the chest caused by stomach acid travelling up towards the throat. We can control this with simple medicine, if needed.
• In rare cases, the stent may slip out of position. We may then need to repeat the procedure.
• Sometimes, it may not be possible to fit or place a stent for technical reasons. If this happens, the IR doctor will talk to you about the situation.

Radiation risks

During an oesophageal dilatation or stent procedure, you are exposed to X-rays. They are a type of radiation called ionising radiation. This may cause cancer many years or decades after you are exposed to it.

You might have some skin redness after the procedure that feels like sunburn. We do not expect this to be permanent. The redness might be harder to notice on brown and black skin. 

Interventional radiology (IR) is when we use medical imaging guidance to do minimally invasive procedures. The amount (dose) of radiation from these procedures is generally low. More complex procedures might involve a medium (moderate) dose of radiation.

The IR doctor and radiographer (health professional who specialises in medical imaging) make sure that:

• your radiation dose is kept as low as possible
• the benefits of having X-rays during your procedure are greater than the radiation risks

Radiation and pregnancy

Radiation can be harmful for an unborn baby. If you are or think that you might be pregnant, it is important to tell a member of your medical team before the procedure. We cannot do any procedure that involves radiation if you are pregnant.
 
If you can become pregnant from sex, you need to use protection (contraception) from the first day of your period until your appointment. This means that you will not be pregnant when you have the procedure.

If the first day of your period has already passed, please contact the interventional radiology (IR) department. We can then give you another appointment within the first 10 days of your period. 

We ask you to sign a pregnancy declaration form before the procedure.

Other treatment options

Sometimes, we recommend surgery but this is usually if cancer has caused the narrowing in your food pipe.

Your doctor has recommended an oesophageal dilatation or stent procedure as the best option for you. However, if you would like more information on surgery, please speak to your doctor.