Esophageal Self Dilation Therapy: An Effective Alternative

Jan 8, 2019 | Kanaaz Pereira, Connect Moderator | @kanaazpereira | Comments (35)

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.

@docdiamond

I am in the process of being diagnosed. It looks like I have type 1 achalasia. Would it be possible for me to send self diaation therapy rather than go through POEM or Heller Myotomy? Jost passing the endoscope into my stomach made me swallow much better for weeks. If you want to try it out on someone, I am otherwise in good condition and would be a good candidate

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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/?search=Achalasia
--Two months after Poem surgery for achalasia:
https://connect.mayoclinic.org/discussion/two-months-after-poem-surgery-for-achalasia/?commentsorder=newest#chv4-comment-stream-header
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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@hopeful33250

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/?search=Achalasia
--Two months after Poem surgery for achalasia:
https://connect.mayoclinic.org/discussion/two-months-after-poem-surgery-for-achalasia/?commentsorder=newest#chv4-comment-stream-header
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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POEM 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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@docdiamond

POEM 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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I 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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@centuryhouse

3 years ago I started having problems with food getting 'stuck' - at times it wouldn't go down my esophagus and would eventually come back up. It gets better at times and worse at others.

In the last 6 months I have had difficulty breathing, feeling like it is difficult to get air down my throat. I'm starting to panic a little, worried that I will suffocate. Sometimes it seems mostly ok, at others I feel a complete restriction on air intake may occur. In the last month it has gotten especially bad.

I have many symptoms of hypothyroidism and a family history of it, so a nodule or other related obstruction may be the cause. I also have acid reflux issues and a family history of GERD, so perhaps that is it. Maybe it is something else...

I lost my insurance after a lay off a few years ago. I have a new job but no insurance for now. I do not have much money. I cannot afford to go to a doctor. Is there a way by which I can get the dilator needed to do this at home?

I'm getting desperate and was thinking of trying to construct something to do this in an emergency, which is how I found this article. I am in the Northern suburbs of Dallas, TX.

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I 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.

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@muddypaws88

I 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.

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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

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