By: Lambros Michailidis, M.D.

You might have heard of food going down the “wrong pipe.” But what should you do if your food struggles going down the right pipe?

With the right treatment, you widen the pipe.

Esophageal dilation, the medical term for stretching your esophagus (or food pipe), can be a life-changing treatment for people whose esophagus has narrowed so much they have trouble swallowing even liquids. But unlike widening a road or letting out the waist in a pair of pants, esophageal dilation does not require major reconstruction, cutting, or surgery.

Instead, the procedure gently stretches your food pipe enough so you can swallow comfortably, through one of two proven methods. And your doctor can perform it as an outpatient procedure, while you are under anesthesia.

If you think you’re ready to stretch, read on.

What’s Behind Your Swallowing Problems

The medical term for an abnormally narrowed food pipe is “esophageal stricture.” A number of conditions can make it happen, and your treatment approach will depend on that cause. These conditions include:

• Gastroesophageal reflux disease (GERD) – Generally known as persistent acid reflux, GERD develops when food and acids back up from your stomach into the esophagus, typically because the muscle that should close after food enters the stomach malfunctions or weakens.
• Barrett’s esophagus – If GERD becomes severe, it can develop into this potentially cancerous condition. Nearly half of people diagnosed with Barrett’s esophagus experience symptoms similar to GERD, including a more severe cough. But many people report little or no symptoms.
• Esophageal cancer – A tumor or cancerous growth can block your food pipe and might require surgical removal. Radiation cancer therapy can lead to strictures up to 18 months after treatment.
• Swallowing disorders (esophageal dysphagia) – Other ailments that can cause your throat to tighten include scar tissue (scleroderma), nerve damage (achalasia) or an irregular ring of tissue in the lower esophagus. Sometimes your doctor will recommend an esophageal manometry be performed to check on the motility or “squeeze” of your esophagus.

Common symptoms of these conditions, outside of trouble swallowing, include lasting heartburn, a sour and/or burning throat, burping, black stools (from blood in the esophagus), and a chronic cough.

2 Ways Your Food Pipe Can Be Expanded

If eating or drinking triggers concern about gagging or getting it down, look out for the above symptoms. Chances are, you should see a gastroenterologist to check out your food pipe for strictures.

Your doctor can treat you by widening or stretching your esophagus. Note, the procedure might not cure all of the above causes, but it can provide welcome relief to the symptoms.

Your physician will likely recommend one of these proven methods:

• An upper endoscopy– In this procedure, your physician can both diagnose and treat strictures by threading a flexible tube equipped with a tiny, lighted camera (endoscope) into your throat. If the endoscope reveals narrowing, the physician will pass either a small balloon or plastic dilators through the tube and use them to slowly widen the esophagus.

• A weighted dilator – This approach involves a weighted, tapered dilating instrument that the physician gently feeds into the narrowed area of your esophagus, to gradually expand it.

In cases of complex strictures, your gastroenterologist might insert temporary, self-expandable stents.

What to Expect During and After Esophagus Treatment

If you choose any of these approaches, plan on fasting for at least six hours beforehand, and line up a reliable ride to drive you to and from the physician’s office. The treatment itself should take less than 30 minutes, and you will not be able to eat or drink for a few hours after.

Following treatment, you might experience a temporary sore throat that can be eased with lozenges. Your doctor will provide instructions on eating in the days after the procedure. The rest, your stretched esophagus will be able to do right on its own.

Click here to read more about esophageal dilation, what to expect, and how to prepare. If you suspect you have a swallowing disorder, read our blog on dysphagia.