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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...
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Hello @docdiamond and welcome to Mayo Connect. I see that this is your first time posting. On Mayo Connect, there are several discussion groups where members discuss their experiences with Achalasia as well as POEM. Here are some links to one of those discussion groups:
--Achalasia
https://connect.mayoclinic.org/search/
--Two months after Poem surgery for achalasia:
https://connect.mayoclinic.org/discussion/two-months-after-poem-surgery-for-achalasia/
As you read these posts, feel free to ask questions and share your concerns by clicking on "Reply" under the post. Has POEM surgery been suggested to you by your medical team?
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1 ReactionPOEM has been suggested yet. I have not been officially diagnosed with achalasia, but that is the most likely diagnosis according to my doctor. I would like to avoid surgery if possible. It does not always work like it is supposed to, and usually results in acid reflux. Self-dilation sounds like a good alternative, but I have not seen where it is used for achalasia.
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2 ReactionsI understand your wanting to avoid surgery, @docdiamond. On Mayo Clinic's website there is an article that describes non-surgical options for treating achalasia. Here is a link to that information:
-Achalasia Diagnosis and Treatment
https://www.mayoclinic.org/diseases-conditions/achalasia/diagnosis-treatment/drc-20352851
I look forward to hearing from you again when you have more information about your diagnosis and possible treatment options.
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1 ReactionI survived oropharyngeal cancer two years ago. As a result , I’ve had difficulty swallowing. It got better for awhile but recently has become more of an issue. After looking around online for options, I stumbled across self dilation. While there are “medical grade” devices out there, I found the most reasonably priced device at siliconenozzles.com.
“The item you ordered will be a smooth shaft at 1 1/8''(1.125'')
diameter. (2.85cm) for the entire length after the smooth tip. The tip
starts at around approximately 0.5'' until it slowly tapers up to the
1.125''.
It was affordable and seems to be working.
This is in no way a recommendation. Only my personal experience.
Dear @muddypaws88 ,
Your recommendations do not align with those of the three medical studies from MN, AZ and Amsterdam for esophageal self-dilation.
Specifically, the diameter of successful esophageal stricture management in those three studies was around 14mm, or .55 inch.
The devices you recommend are more than double that size.
Also, the website you have recommended in your two posts seems to be for sexual purposes, not medical purposes. Just an FYI.
cc @kanaazpereira
Anybody needing help with esophageal dilations feel free to contact me. I did it for several months until I stopped needing it and I can share everything I learned about it.
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2 Reactions@mayofan5 Hi there, everyone has different needs according to how bad their strictures are. When I got tired of going to endoscopy I decided to do my own dilations and replicate what doctors did at endoscopy so I bought three dilators: 17, 18.5 and 20 mm. I would use each 2 or 3 times starting with thinnest obviously. After 3 or 4 months the strictures stopped and I haven’t done dilations since 4 months ago. This has been my experience, however I know other people use smaller sizes . Everyone should consult with a doctor that has experience doing bougie dilations prior to doing it themselves. I did.
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4 Reactions@manuelo How did you get started? Where did you purchase the dilation tube?
@jrbkan well, I am a little impatient so I bought the first one on ebay USED! Hahaha my doctot was laughing when I told him. Anyway, I cleaned it real good and went to doc so he can show me how to use it. After that I asked doc to ordet the bigger sizes for me through hospital. I can give you more details if you dm if needed.
@manuelo Thanks for getting back to me. I appreciate it. Ha! I don't think my doctor would be amused if I told him that I wanted to learn how to self-dilate.
I ordered a tube from Ebay and it should arrive in a few days. What was it like learning to do this?
Can you give me some pointers on how to get past the gag reflex?
Also, how do I dm you?