Does empiric esophageal dilation benefit dysphagia when endoscopy is normal?

Area of Science:

• Gastroenterology
• Esophageal Diseases
• Diagnostic and Therapeutic Endoscopy

Background:

• Dysphagia evaluation often includes esophagogastroduodenoscopy (EGD), but some patients present with normal findings, leaving management unclear.
• The optimal approach for patients experiencing dysphagia despite a normal EGD requires further investigation.

Purpose of the Study:

• To assess the efficacy of empiric esophageal dilation in patients with dysphagia and normal EGD findings.
• To differentiate treatment response based on the type of dysphagia (solids only vs. solids and liquids).

Main Methods:

• A retrospective review of 40 consecutive patients undergoing empiric esophageal dilation during EGD for dysphagia with normal endoscopic findings.
• Patients were categorized into two groups: dysphagia to solids only, and dysphagia to solids and liquids.
• Outcomes were assessed based on complete or partial resolution of dysphagia post-dilation.

Main Results:

• Complete dysphagia resolution occurred in 95% of patients with solid-food-only dysphagia (19/20).
• Only 12% (2/17) of patients with dysphagia to both solids and liquids achieved complete resolution; 35% experienced partial improvement.
• The difference in response between the two groups was statistically significant (P < 0.0001).

Conclusions:

• Empiric esophageal dilation is a beneficial and often long-lasting treatment for patients with dysphagia to solid foods and normal EGD findings.
• This therapeutic approach yields limited success in patients with dysphagia affecting both solids and liquids.