Endoscopic Dilatation Therapy Using a Small Caliber Balloon for Esophageal Achalasia

Balloon dilation therapy under direct endoscopic vision was performed in three patients with esophageal achalasia. The Rigiflex through-the-scope balloon dilator, with a maximum diameter of 10-25 mm, was used for dilatation, with a 10-min inflation period. In all patients, dysphagia and regurgitation improved, body weight increased, and esophagography revealed a decrease in esophageal diameter. Our approach differs from standard methods used in Europe and America, in that the balloon has a smaller diameter and the duration of inflation is longer. Although our balloon dilator was small caliber, satisfactory results were obtained because of the longer duration of inflation. We conclude that balloon dilatation is the first choice for treatment of esophageal achalasia, and that to increase the safety of this technique, it is necessary to begin such treatment with a small caliber balloon under direct endoscopic vision.