Stricture Dilation

What is Stricture Dilation?

Stricture dilation is a medical procedure used to widen strictures or narrow areas of the digestive tract. These strictures can occur due to various conditions, such as inflammatory bowel disease, radiation treatment, cancer, and scar tissue from surgery. A gastroenterologist typically performs the procedure, which involves inserting an endoscope through the mouth or anus into the digestive tract.

Who is Suitable for Stricture Dilation?

The procedure is suitable for individuals with strictures in their digestive tract that are causing symptoms such as difficulty swallowing, abdominal pain, bloating, nausea, and vomiting. Your gastroenterologist may recommend stricture dilation if they suspect the narrowed area is causing an obstruction or difficulty passing food through the digestive tract. 

Not all strictures require dilation; the procedure's suitability will depend on the individual's medical history and specific circumstances.

What are the Benefits of Stricture Dilation?

There are several benefits to stricture dilation, including:

• Alleviates Symptoms: Stricture dilation can significantly relieve individuals experiencing symptoms such as abdominal pain, bloating, nausea, and vomiting. By dilating the strictured area it allows for easier passage of food and digestive juices through the digestive tract, reducing the symptoms associated with strictures.
• Improves Digestion and Nutrient Absorption: Stricture dilation can improve an individual's ability to digest food and absorb nutrients. This is particularly important for individuals with strictures causing malnutrition or weight loss.
• Minimally Invasive: Stricture dilation is a minimally invasive procedure, which means that it can be performed as an outpatient procedure, and the individual can return home on the same day. This reduces the need for hospitalisation and allows for a faster recovery.
• Cost-effective: Compared to more invasive procedures such as surgery, stricture dilation is a cost-effective treatment option for strictures in the digestive tract.
• High Success Rate: Stricture dilation has a high success rate, with most individuals experiencing relief from symptoms and improved digestive function after the procedure. Some patients may require multiple procedures.

What are the Types of Stricture Dilation?

There are two main types of stricture dilation:

• Balloon dilation is the most common type of stricture dilation. It involves inserting a deflated balloon through the endoscope and positioning it within the narrowed area. The balloon is then inflated to widen the stricture, and the endoscope is removed.
• Bougie dilation involves inserting a tapered tube, called a bougie, through the endoscope and into the narrowed area. The bougie is gradually widened to stretch the stricture, and the endoscope is removed. Bougie dilation is less commonly used than balloon dilation.

Alternative Options to Stricture Dilation

While stricture dilation is an effective treatment option, alternative options are available depending on the underlying cause of the strictures. These options may include the following:

• Medications such as corticosteroids, immunosuppressants, and biologics may be prescribed to treat strictures caused by inflammatory bowel disease.
• Endoscopic radial incision using an electrosurgical knife is another minimally invasive procedure that may be recommended for certain strictures.
• Stenting involves placing a metal or plastic tube inside the narrowed area to keep it open. This option may be recommended for strictures caused by cancer or scar tissue from surgery.

What to Do Before a Stricture Dilation?

Before undergoing stricture dilation, there are a few things that you should do to prepare for the procedure:

• Notify your gastroenterologist of any medications you take, including over-the-counter medicines and supplements.
• Follow your gastroenterologist's instructions regarding food and drink before the procedure, which may include fasting for a certain period.
• Arrange for someone to drive you home after the procedure, as the sedative used during the procedure may impair your ability to drive.

What Happens During Stricture Dilation?

• Preparation: You will be given a sedative to help you relax during the procedure.
• Insertion of Endoscope: Your gastroenterologist will insert an endoscope through your mouth or anus and into your digestive tract. The endoscope is a flexible tube with a camera attached, allowing your gastroenterologist to see inside your digestive tract.
• Location of the Stricture: Once the endoscope reaches the narrowed area, your gastroenterologist will identify the location and severity of the stricture.
• Insertion of Balloon or Bougie: Your gastroenterologist will insert a deflated balloon or tapered tube, called a bougie, through the endoscope and into the strictured area.
• Inflation or Widening: The balloon or bougie will gradually inflate or widen to stretch the strictured area. This allows for easier passage of food and digestive juices through the digestive tract, reducing the symptoms associated with strictures.
• Removal of Balloon or Bougie: Once the strictured area has been dilated, the balloon or bougie will be deflated and removed, and the endoscope will be removed from your digestive tract.

The procedure typically takes 30 minutes to an hour, depending on the severity and location of the strictures.

What Happens After a Stricture Dilation?

After the procedure, you will be monitored in a recovery area until the sedative wears off. You may experience mild discomfort, such as bloating or gas, which should subside within a few hours. Your gastroenterologist will provide instructions on when you can resume eating and drinking and any specific post-procedure care instructions.

Post-procedure Care Instructions

Following stricture dilation, it is essential to follow post-procedure care instructions to ensure a smooth recovery and minimise the risk of complications. This may include the following:

• Rest and hydration: It is essential to rest and drink plenty of fluids for the first few days after the procedure to help your body recover.
• Diet modifications: Your gastroenterologist may recommend a modified diet for a few days after the procedure to allow your digestive tract to recover.
• Medications: Your gastroenterologist may prescribe medications to alleviate discomfort or prevent infection.
• Follow-up appointments: Your gastroenterologist will schedule follow-up appointments to monitor your progress and ensure the strictures have not recurred.

Stricture Dilation Prognosis

The prognosis for stricture dilation depends on the underlying cause of the strictures. If the strictures are caused by inflammatory bowel disease, the prognosis may be more favourable, as medication may help prevent them from recurring. However, the prognosis may be more guarded if the strictures are caused by cancer or scar tissue from surgery. 

In general, stricture dilation has a high success rate, and most patients experience relief from symptoms such as abdominal pain, bloating, and nausea.

Stricture Dilation Risks

While stricture dilation is generally safe, there are potential risks and complications associated with the procedure. These risks may include the following:

• Perforation: In rare cases, the endoscope, balloon, or bougie used during the procedure may puncture the digestive tract, leading to perforation.
• Bleeding: The procedure may cause minor bleeding, which usually stops on its own. However, more significant bleeding may occur in rare cases requiring medical attention.
• Infection: There is a small risk of infection following the procedure, which may require antibiotics.
• Narrowing of the stricture: In some cases, the stricture may narrow again after the procedure, requiring repeat dilation.
• Adverse reaction to sedatives: Some patients may experience an adverse reaction to the sedative used during the procedure.

What if Stricture Dilation is Delayed?

If stricture dilation is delayed, it may lead to complications such as a complete blockage or obstruction in the digestive tract, which may require more invasive procedures such as surgery. Sometimes, delaying the procedure may also result in more severe symptoms, such as weight loss, malnutrition, and dehydration.



What is the Cost of Stricture Dilation?

The cost of stricture dilation can range from approximately $1,500 to $5,000, with most private health insurance plans covering a portion. If you are considering the procedure, consult with a gastroenterologist to determine the exact cost and discuss any questions or concerns.