Esophageal dilation is a treatment option for patients with achalasia. During esophageal dilation (also called pneumatic dilation), an endoscopic tube is inserted through the mouth and into the esophagus. A balloon is expanded inside the esophagus to stretch muscle fibers inside the lower esophageal sphincter (LES).
Esophageal dilation is best performed by a gastroenterologist who specializes in achalasia and who has performed many esophageal dilations because there is a risk of perforating the esophagus.
Dilation causes some scarring which may increase the difficulty of Heller myotomy if this is needed later. Gastroesophageal reflux (GERD) occurs after pneumatic dilatation in some patients.
Pneumatic dilation is most effective long term in patients over the age of 40; the benefits tend to be shorter-lived in younger patients. It may need to be repeated with larger balloons for maximum effectiveness.