Esophageal Self Dilation Therapy: An Effective Alternative

Jan 8, 2019 | Kanaaz Pereira, Connect Moderator | @kanaazpereira | Comments (28)

Many patients have difficulty swallowing due to narrowing of the esophagus. Benign esophageal strictures can be challenging to treat, with the main treatment being endoscopic dilations. Often, repeated upper endoscopies are required to maintain successful swallowing. These procedures are costly and their efficacy can be short-lived. Gastroenterologists at Mayo Clinic offer a more convenient and effective method that may lessen the frustrations and challenges of repeated endoscopies–esophageal self dilation therapy or ESDT.

Esophageal self-dilation involves teaching the patient how to dilate their esophagus orally, on a routine basis with the help of a simple medical device–a polyvinyl dilator. Besides being successful, researchers also found that ESDT could lead to the removal of feeding tubes that were previously required to get food into the gastrointestinal tract.

Mayo Clinic gastroenterologist, Dr. Magnus Halland, M.D., encourages patients with swallowing difficulties due to narrowing of the esophagus, to visit Mayo Clinic to see if they may be candidates to learn ESDT. Dr. Halland also talks about the open clinical trial linked to ESDT at Mayo Clinic.

Meet other people talking about esophageal disorders on Mayo Clinic Connect. Here are some discussions you might like to view–join the conversation, share experiences, ask questions, and discover your support network...

Interested in more newsfeed posts like this? Go to the Gastroenterology & GI Surgery blog.

@drupoint

I am about to undergo the self dilatation therapy.

I had one question.

As you pass the Dilator , do you try to swallow it as it goes down to avoid it entering your airway ??????

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Good question, @drupoint. I'm tagging @peggyschr @lori57216 @rlp63 and @jmfarris to make sure they see it and hopefully to provide their experience about swallowing and avoid the dilater entering the airway.

When will you start self-dilation therapy, Dru?

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@colleenyoung

Good question, @drupoint. I'm tagging @peggyschr @lori57216 @rlp63 and @jmfarris to make sure they see it and hopefully to provide their experience about swallowing and avoid the dilater entering the airway.

When will you start self-dilation therapy, Dru?

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If I go ahead with it , it will not be until the New Year.

Interested very much in this bit of it. !!

Cheers
Bruce

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@drupoint

If I go ahead with it , it will not be until the New Year.

Interested very much in this bit of it. !!

Cheers
Bruce

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Hi @drupoint my name is Rickey and I have been self dilating for about a year. To answer you question yes as you lower the bougie into your mouth and throat as you get the tapered in down into your throat or past your tongue you swallow to make sure it goes into esophagus instead of wind pipe. After or as you swallow and lower a little further if you aren't sure you can swallow again and lower some more. In this whole year I have only got it in the airway once and I knew immediately so it never actually went into the wind pipe. I just pulled it back a little and swallowed and lowered again. It really isn't as hard to get it going down the right way. If you gag its okay just don't pull it out. Relax and start lowering again. You can breathe as you go so no rush. Sometimes I go all the way with one gag and sometimes I may gag 3 times. It helps me and I am glad I gave it a try. Hope this helps.

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@rlp63

Hi @drupoint my name is Rickey and I have been self dilating for about a year. To answer you question yes as you lower the bougie into your mouth and throat as you get the tapered in down into your throat or past your tongue you swallow to make sure it goes into esophagus instead of wind pipe. After or as you swallow and lower a little further if you aren't sure you can swallow again and lower some more. In this whole year I have only got it in the airway once and I knew immediately so it never actually went into the wind pipe. I just pulled it back a little and swallowed and lowered again. It really isn't as hard to get it going down the right way. If you gag its okay just don't pull it out. Relax and start lowering again. You can breathe as you go so no rush. Sometimes I go all the way with one gag and sometimes I may gag 3 times. It helps me and I am glad I gave it a try. Hope this helps.

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Thanks for the Reply Rickey.

Duly noted all respects. I am well over having it done without sedation , roughly every 6 weeks.

Much rather this less traumatic approach , on a daily basis.

I've had quite a few good pointers from this Site.

I live approximately 20 miles South of Hobart , in Tasmania.

We don't know of anyone, locally that does self dilatation, there might not even be anyone.

Cheers and Thanks
Bruce

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@drupoint

Thanks for the Reply Rickey.

Duly noted all respects. I am well over having it done without sedation , roughly every 6 weeks.

Much rather this less traumatic approach , on a daily basis.

I've had quite a few good pointers from this Site.

I live approximately 20 miles South of Hobart , in Tasmania.

We don't know of anyone, locally that does self dilatation, there might not even be anyone.

Cheers and Thanks
Bruce

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I don't know of anyone anywhere near me who self dilates. My GI doctor told me how to do it and watched me do it the first time and since then I have done it without instruction. I too was having to dilate every 6 weeks. After being sedated and dilated 10 times I decided I had to do something else. All of my other doctors are amazed that I self dilate. Good luck.

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Thank You very much for all your help.

Cheers
Bruce

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@magnushalland

Best wishes for your husband. It is fortunately only a small group of patients who simply don't stay open very long after endoscopic dilatations done under anesthesia. In such patients, many of whom have undergone 10 or more endoscopies, we teach self-dilation, which helps maintain the opening which has recently been achieved during an endoscopic procedure.

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Hi, I've had multiple dilations after esophageal cancer surgery. I'd like to learn more about self-dilation. How might I proceed? Thanks, Mike Lewis

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@mikelewis220

Hi, I've had multiple dilations after esophageal cancer surgery. I'd like to learn more about self-dilation. How might I proceed? Thanks, Mike Lewis

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@mikelewis220, if you would like to consult Mayo Clinic experts about self-dialation, please request an appointment to find out more here: http://mayocl.in/1mtmR63

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