Self-dilation for refractory oesophageal strictures: an Auckland City Hospital study

To determine the demographics, indications and long-term outcomes of patients using self-dilators for refractory oesophageal strictures.

Patients with oesophageal strictures who performed self-dilation were analysed retrospectively. Patients who were still alive were also interviewed via telephone.

A total of 8 patients were analysed and 2 patients had since died. Most patients were in the 20-29 age group (n=4) when they first attempted self-dilation. The most common cause for oesophageal strictures was ingestion of corrosive (n=5). Each patient underwent on average 20 endoscopies (including endoscopic dilations) before attempting self-dilations. 1 patient developed oesophageal perforation during endoscopic dilation. 3 patients were still using self-dilators at the time of analysis. All the patients were only using lubricants (K-Y jelly) and none required topical anaesthetic such as Xylocaine throat spray.

Oesophageal self-dilators were well-tolerated and complications were rare. By reducing the need for endoscopies, they are potentially cost-effective. However, patients must receive proper education before they are able to administer this treatment with confidence.