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Dysphagia without endoscopically evident disease: to dilate or not?
J S Scolapio1, C J Gostout, K W Schroeder
1Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, Florida, USA.
The American Journal of Gastroenterology
|March 10, 2001
Summary
Empiric esophageal dilation does not benefit patients with dysphagia and normal endoscopy. This study found no significant difference in symptom improvement between balloon dilation and sham procedures.
Area of Science:
- Gastroenterology
- Esophageal Disorders
- Interventional Endoscopy
Background:
- Dysphagia is a common symptom, but its cause is not always evident on upper endoscopy.
- The efficacy of empiric esophageal dilation in such cases remains unclear.
Purpose of the Study:
- To evaluate the symptomatic benefit of empiric esophageal dilation using a through-the-scope balloon in patients with solid food dysphagia and normal upper endoscopy.
Main Methods:
- A prospective randomized controlled trial was conducted.
- Patients with dysphagia and normal endoscopy were randomized to balloon dilation or a sham procedure.
- Symptom improvement was assessed using validated questionnaires and a visual analog scale at multiple time points.
Main Results:
- No significant difference in dysphagia improvement was observed between the balloon dilation and sham groups at day 1, 3 months, or 6 months.
- Baseline characteristics and antireflux medication use were comparable between groups.
- No complications were reported in either group.
Conclusions:
- Empiric dilation is not supported for patients with dysphagia and no identifiable endoscopic cause.
- This finding suggests alternative diagnostic or therapeutic approaches may be needed.