How many times can you be scoped to enlarge the esophagus? Mine seems to be closing off every three months or so.

B.J.

Doctors refer to the procedure used to "enlarge the esophagus" as esophageal dilation. In this procedure, an esophagus narrowed by scarring (strictures) is literally stretched open. Most strictures are a result of the inflammation caused by long-standing gastroesophageal reflux disease GERD). Other causes of strictures in the esophagus include tumors, radiation to the chest, ingestion of caustic substances (typically in a suicide attempt) and certain medications (including chemotherapeutic agents).

Patients with strictures experience difficulty swallowing solid foods and the sensation that food is "sticking" in their chests. Esophageal strictures are usually diagnosed during an endoscopic or barium examination of the upper GI tract.

There are several different methods that can be used to perform esophageal dilation through an instrument called an endoscope (a flexible tube that carries a viewing device and other surgical tools down the throat). One method involves using a set of tapered cylinders to gradually enlarge the diameter of the esophagus. This system is effective for very severe and tight strictures, in which multiple endoscopic dilating sessions may be needed. Certain strictures are mild and may only require widening with a larger, more flexible cylinder. Other dilating systems include one in which a deflated balloon is passed into the esophagus and centered over the stricture. The balloon is then inflated at the stricture, stretching the esophagus to a predetermined size. All of these methods are very effective and safe if performed by experienced endoscopists in the right circumstances.

Generally, patients with benign strictures (those not associated with cancer) respond well to dilation. However, repeat procedures may be required, usually at infrequent intervals. It is important that patients who receive dilation also take acid-suppressive medications to aid in proper healing and reduce the risk of stricture recurrence. In a patient who does not respond well to dilation, several factors must be considered, including whether the method being used for dilation is aggressive enough and whether cancer has been ruled out (strictures caused by cancer tend to be harder to treat). To answer your specific question, there is really no limit to the number of dilations that can be done.