"Dilatation can be very successful in treating achalasia, and provide relief from its symptoms for as long as a decade."
Michael Manfredi, MD, associate director, Endoscopy Program
Dilatation is a procedure that helps children with problems affecting the upper digestive system, such as swallowing. It’s faster and less expensive than a traditional operation.
At the bottom of the esophagus—the tube that carries food from the mouth to the stomach—is a band of muscles that opens and shuts when you swallow. This does two things:
- It allows food into the stomach.
- It keeps the stomach's contents from rising into the esophagus during digestion.
Sometimes these muscles grow weak, and don’t open the right way when you swallow (achalasia). This might result in pain, difficulty swallowing or food getting stuck in the esophagus.
During dilatation, a doctor opens the band of muscles at the bottom of the esophagus with a small balloon. This allows a patient with achalasia to again swallow normally.
When do doctors order dilatations?
Doctors may order dilatations for children with strictures (narrowing of the esophagus). Strictures might be:
- present at birth (congenital)
- the result of a condition such as gastroesophageal reflux (GERD)
- the result of swallowed chemicals
- the result of treatment for esophageal atresia
About 98 percent of dilatations are esophageal. They could also be performed on the pylorus muscle in the stomach, and the colon.
Dilatation at Children’s Hospital Boston
Here at Children’s, dilatation is performed by the experienced clinicians of our Gastroenterology Procedure Unit (GPU)—a full-service unit providing an array of diagnostic and therapeutic endoscopy procedures in a safe, comfortable environment.
Lots of gastroenterology (GI) doctors can perform dilatations, but pediatric expertise is crucial. Our specialists are very highly experienced, performing close to 100 per year.
Our team includes 19 attending physicians, 12 nurses and 6 endoscopy technicians who support the day-to-day practice of the unit. We also assist in the care of children with life-threatening cases in other areas of the hospital, such as the intensive care and surgical units, using our portable equipment. All nurses and physicians are certified in pediatric advanced life support (PALS).
Elliott Cleckler was born with long-gap esophageal atresia— a serious condition that is notoriously difficult to treat. In this short video series, his parents, Jay and Heather, share their story.
Dilatation: Reviewed by Michael Manfredi, MD
© Children’s Hospital Boston, 2011