What is EGD with Dilation?
EGD (Esophagogastroduodenoscopy) with dilation is a minimally invasive medical procedure used to diagnose and treat conditions of the upper gastrointestinal (GI) tract, particularly when there is narrowing (stricture) in the esophagus, stomach, or duodenum. During the procedure, your gastroenterologist will pass a thin, flexible tube with a camera and light called an endoscope through the mouth and into the GI tract.
Indications for EGD with Dilation
Your physician may typically recommend EGD with dilation to:
- Widen a stricture (usually caused by scarring from acid reflux, radiation, eosinophilic esophagitis, cancer, or previous surgery).
- Relieve symptoms such as difficulty swallowing (dysphagia) or food getting stuck.
Procedure for EGD with Dilation
EGD with dilation is typically done in an outpatient setting, like an endoscopy suite or hospital, and takes about 15 to 45 minutes. You will need to fast for at least 6-8 hours before the procedure to ensure your stomach is empty.
In general, the procedure involves the following steps:
- You will be placed under moderate sedation or conscious sedation to help you relax and minimize discomfort. You may also receive a local anesthetic to numb your throat.
- Your physician will gently insert an endoscope through your mouth and down your throat into the esophagus, stomach, and duodenum (the first part of the small intestine). To help guide your physician, an imaging technique called fluoroscopy (real-time X-ray) may also be utilized.
- The camera on the endoscope transmits images to a monitor, allowing the doctor to carefully inspect the GI tract for any abnormalities like ulcers, inflammation, or strictures.
- If a stricture or narrowing is found, the physician performs dilation to widen the narrowed area:
- Balloon Dilation: A deflated balloon is passed through the endoscope into the stricture. It is then inflated to gently stretch the area, held in place briefly, and then deflated and removed.
- Bougie Dilation: A series of increasingly wider flexible tubes (bougies) are passed over a guidewire or directly into the stricture to gradually stretch it to the desired width.
- The goal of dilation is to relieve any blockages and make it easier for food and liquids to pass through.
Post-Procedure Care
After an EGD with dilation, the patient is monitored in a recovery area until the effects of sedation wear off, which typically takes about 1 to 2 hours. A mild sore throat, bloating, or cramping may occur but usually resolves quickly. Most patients can go home the same day, but they should not drive or operate machinery due to lingering sedation effects. Eating and drinking can typically resume after a few hours, starting with light foods. Patients are advised to avoid hot, spicy, or hard-to-swallow foods for a day or two. Follow-up appointments may be scheduled to assess the effectiveness of the dilation and monitor for the recurrence of symptoms.
Risks and Complications
Risks and complications of EGD with dilation are rare but can include:
- Perforation (a tear in the esophagus or GI tract)
- Bleeding
- Infection
- Reactions to sedation
- Chest pain or sore throat
- Recurrence of stricture
