Esophageal Dilatation VS Self Dilation

[@ChrisHansonCanada]

My swallowing difficulties come and go. This past week has been especially difficult, with the food just sitting in my esophagus and not moving. I have to take several sips of water for it to go down. I was fine last week.

[@Mikenel777]

I used to take a small tub of yoghurt everywhere I went and if I had problems swallowing I would eat the yoghurt and bingo it would push the obstruction through. That was before I had chemo and radiation which has cleared the obstruction.

[@ALightInTheDark7]

It's an allergy, it's called eoe .. watch what your eating and then you will see what your allergy is

[@delsings]

I've been grappling with swallowing problems for years now myself, just commented about it here too. Just wanna say I see you and I hope you've been finding solutions with your doctors! Take care

[@jaredkurimski3010]

How are you now?

[@ChrisHansonCanada]

@@jaredkurimski3010 Much better. It seems to be related to stress and anxiety.

[@delsings]

Thank you for this information, this may prove very helpful to me and my medical team. Here's some about my health journey, it's a long read, but maybe it may help others. I've been struggling with excess mucus ever since I had pneumonia back in the summer of 2021, struggling with a poor immune system for long before then, and it turned into an inability to swallow correctly (dysphagia) for a couple years now. At this point I've already had years of an inability to yawn, and burping was already a hit and miss sensation that I couldn't self induce, but over time burping was harder to fully do as well. I also haven't been able to throw up for a couple years now (even if trying to make myself gag and induce vomiting, all I'd get is head pressure and a very red face). Over these few years I've also ruled out having asthma (likely a misdiagnosis for 20 ish years), where I was taking inhalers and eventually flonase nasal sprays for, but turns out I have "laryngeal tightening" and using those inhalers made my symptoms worse. With my swallowing issue, at first it would feel stuck halfway in the swallow, or get trampolined so that it would turn into me trying to push out mucus instead. I'd also have boughts of "acid reflux" moments, which for about a decade I'd battle on and off with natural remedies, since I was warned way back not to take antacid medications since I had 4-5 months of C diff (only 2 antibiotics for it, tried the pill type 2 times didn't work so had to drink the hand mixed liquid form to finally get it handled) and it could trigger it again. A couple years back I was put onto the generic of pepcid, being assured that it didn't carry that c diff trigger risk, and I used 40mg nightly for a couple years (and eventually omaprazole for a couple weeks, because I started having burps that would end in a rush of fluid coming up that would try to choke me). But I'm now off of both due to what I realized was an extensive list of very bad side effects. At that time weaning off was a personal decision because ENT at the time suggested I double my pepcid intake. It's one piece of advice I'm glad I didn't follow because some of the side effects have subsided since and I've been off pepcid now for 8 months maybe? I am back to more natural alternatives for time being and diet changes, rolaids help when foods give me acid, but the swallowing problem persists. I've done modified barium swallow testing where they said they "found no issue" and that I "seem to be swallowing according to the tests". I've seen Gastros and ENTs (and also have been hot potatoed between them, with the specialists thinking the other would better help me). I had seen a vocal therapist for a couple of remote sessions, but my swallowing issue was in the way of the work so that went on pause. Ears have also been an issue, getting clogged up or getting light tinnitus moments and sometimes dizziness. I started wondering if there may be a eustacion tube problem, but it still hasn't been figured out even after hearing/pressure tests (been using a product called Big Wave eardrops that seem to be helping some but I digress). Eventually I developed a "clicking" and knocking sensation in my throat with swallowing as well for at least a year now. And lately I've been passing out more often so a sleep study is on the way to rule out narcolepsy. During the fall of last year results from a genetic test came back and turns out I have Ehlers-Danlos syndrome (EDS) type 6, and met the self test criteria for Hypermobile type EDS, so I started factoring that in with doctors, especially since I also suffer chronic pain and scoliosis, pain that has kept my art business on hold for over 5 years now (started practicing my singing throughout this time to at least be doing something but progress has been slow due to these autonomic problems). I basically have been stuck in my house for years unless going to doctors, but over the last 6 months or so I'm startjng to venture out to some non medical places again, always with mask at the ready though. ENT team was pretty convinced they can't help until I rule out acid reflux, after putting a camera down my nose a couple different appointments to look at the state of my vocal flaps and that surrounding area which all looked healthy to them. So my gastro finally performed an upper endoscopy at the end of December '23, where they planned to also staple install an acid sensor to monitor for 48 hours. They didn't end up installing the sensor since they found both a hiatial hernia trying to connect my stomach top to my diaphragm, and a webbing of mucus constricting the base of my esophagus called a "Schatzski's ring" so they dialated me there. But the swallowing issue persists. Finding this info gives me some real hope about all of these problem juggles, so I'll bring this up with my gastro next time I get to see her. She did mention surgery may be needed for it but I was unclear what that meant. Thanks to anyone who read this and if you are also struggling for answers, don't give up! I know how hard, scary, and frustrating it all can be.

[@MarkCooperMD]

Thanks for sharing. Glad you found it helpful. Hope things continue to get better.

[@rschmorr]

i’ve been professionally “bougied” a few times now. where can a lay-person buy an esophageal dilator?

[@aubreywhite8008]

My doctor refuses to do this again as last time my esophagus was perforated and I had to be in hospital after they dilated my esophagus

[@MarkCooperMD]

What’s your condition?

[@Aztonio]

When you talk in mm, it's about the additional stretch, but then what is the total "basic diameter" in centimeters ?

[@MarkCooperMD]

The base diameter varies from individual. I’ve seen as narrow as 2mm. Normal is near 3cm. Adequate chewing should reduce food to less than 15mm. So symptoms become prominent when the esophagus has narrowed to smaller than that.

[@Aztonio]

@@MarkCooperMD Okay thanks for confirmation.

[@squirrelattackspidy]

I've had this done twice. Anywhere between 3-5k per treatment out of pocket. Second time I've had problems with my vocal cords. I have been calling around trying to find someone to go through this self-dialation technique. Nobody in my area does this.

[@tbaby5650]

How are u now . Does ir back left burn with heartburn

[@squirrelattackspidy]

@@tbaby5650 I'm still here so that's a bonus! :) I didn't have the symptoms you are experiencing. Occasional acid reflux but definitely have a stricture.

[@squirrelattackspidy]

@@abhishekroy8646 No bueno and yes I do but can't afford it. Healthcare in the USA.

[@christylee9552]

I’m wide awake watching my fiancé sleep because he’s so hard headed and won’t seek treatment. He tried to eat dinner and on his 3rd bite he felt a piece of turkey lodge and is has yet to pass 6 hours later. It has not affected his breathing. Liquids do not push it but instead he feels like it’s only piling up. He promises to go to the ER in the morning if no improvement. How does someone sleep thru this? I can’t and I’m not injured one. This happens often but only one other time this bad. It had to be removed and was advised to have his esophagus stretched. Obviously he never followed thru.

[@MarkCooperMD]

I’m guessing he’s fairly young? If so then EoE is a likely cause of having these symptoms early in life. I hope he pursues treatment - it can be scary to face your health.

[@matthewm4790]

Does throat dilation always help with EOE

[@christylee9552]

@@MarkCooperMD I missed your message, ty for responding! He’s 54 and finally made his way to Vanderbilt in Nashville. He had the stretching procedure and likely will need to do again.

[@AlanStevens-g4o]

I did the barium swallow based on my having esophageal spasms, they found out I have narrowing at the base of my esophagus. They said that could be what's causing the spasms, is this true? They want to dilate me asap. Will this fix the problem and what side effects is there.

[@ayshwan]

Have You diagnoned with Achalasia? Go for Dialtion. It will definitely help.

[@Beloved20223]

Can a moderate stenosis/stricture due to EOE go away with food elimination diet, steroids, and a PPI? Or only by dilation?

[@netkotreci3135]

How long a person needs to have gerd and got esophageal strictures?

[@lisaconner7609]

nooo, am too inflamed to dilate, just found out at my endoscopy sadly, stageD esophagitis

[@nicoc7024]

Do you have a video on long term ppi use?

[@MarkCooperMD]

On the todo list. Thanks for watching.

[@delsings]

​@@MarkCooperMDseconding this request if it hasn't been made already. I ended up with a ton of bad side effects from ppi.

[@kellyflanagan4501]

I was wondering if you could tell me why ever since I had an endoscopy with the esophageal stretching I’ve had severe silent reflux? I had never had it before and that day after the procedure is the day it started and I’ve had it since. That was over 4 years ago. Is there anything I can do to fix this? I’ve tried everything - ppis, alginates, eating early, no acid foods, etc. It all helps to some degree, but it’s constant and seems like I’ll have it forever.

[@afshanfatima7164]

Hi need ur suggestion my mother has been diagnos with esophagus grossly dilated......please tell us something

[@MarkCooperMD]

This can occur with age and some unusual conditions. It results in trouble swallowing for reasons different from those discussed in the video. Thanks for watching.

[@ancientknowledge525]

I had an allergic reaction to an antibiotic Clindamycin and ive had silent reflux prior but not swallowing issues. I don't know what's going on. I'm now having small pieces of food go up in my sinuses and I blow out my nose. I have a GI appt on the 10th. I'm constantly clearing my throat,.hyper salivation and food stuck at the bottom and won't go down or comes up higer causing me to clear my throat. Also shortness of brearh when bending. Cardiac okay at ED. They told me to see a GI. What does my symptoms sound like? I'm scared. I'm not sleeping hardly at all due to regurgitation.

[@matthewm4790]

It sounds like EOE. You need to start chewing your food very small. Eat at a slower pace. If food feels stuck, take small sips of Coca Cola it will work. You have stricture in your lower esophagus, so you’re not going to choke fully. I have had this condition for 4 years. I feel like I can treat this disease myself lol

[@davidconley4726]

Can self-dilation work for someone with achalasia?

[@staceytaylor3188]

Since My Mom’s Esophagectomy she makes noises. Do You have any advice on how to control the noises? She takes Tums because the noise makes he nauseous while it is going on.

[@isolatedmortalityband5718]

I'm trying to do death metal vocals, and I need to know how to dilate my throat without any kind of instrument.

[@delsings]

Same, that's one of my singing goals too. Wishin you the best with your throat issues 🤘🎵

[@isolatedmortalityband5718]

\m/@@delsings

[@ChrisP3000x]

update?

[@isolatedmortalityband5718]

@@ChrisP3000x ? I haven't learned anything.

[@isolatedmortalityband5718]

@@ChrisP3000x Which sucks because I almost have a death metal album done.

[@californiadoll6273]

TMI: my boyfriend is extremely thick and I cannot physically deep throat him, I was curious to see if it's even possible to learn to stretch my throat over time. So you're saying it's possible? I just want to know I am understanding correctly.

[@Hello12-n6f]

Lol

[@Man.Utd20]

What about surgery can it the solution

[@MarkCooperMD]

Depends on circumstances but yes it can be.

[@Man.Utd20]

@@MarkCooperMD Thanks doc.But if you’re esophagus damaged and narrowing by the acid of stomach and they suggest to you to do surgery will it come back again the symptom after surgery the narrowing

[@dinimutia9289]

How much cost for esophageal dilatation?

[@MarkCooperMD]

That answer varies widely by location and site of care (hospital vs. outpatient).

[@fulton560]

I can’t imagine doing this myself. How do you breathe while that’s in there?

[@MarkCooperMD]

Through your nose.

[@moneypox2628]

Peppermint oil is a smooth muscle relaxant and might help ease esophageal spasms

[@MarkCooperMD]

Peppermint oil has more tendency to relax the lower esophageal sphincter and worsen reflux. Peppermint oil is more effective for lower GI symptoms.

[@MetalheadOv666]

I just got my esophagus dilated to 20mm this morning! Not sure if 14mm is normal cuz my GI dr said 16 is. I got 18,19, then 20mm balloon to stretch it and have to every 3-4 months. Usually only lasts for maybe a month or so and I’ve been getting it done since 2015

[@MarkCooperMD]

Cool. Yes nearer 20 is normal but symptoms are diminished once you’re dilated to 14. Thanks for watching

[@abdullahihusseinabdifoodey7901]

How are you now? We have same problem.😢

[@lakenroth2174]

Hello I have Cerebral Palsy and everything is severe with me and my esophagus is severe also

[@KellyMartin-v8h]

I did this myself when I was in the fifth grade. It really sucks

[@MarkCooperMD]

Sounds like a dangerous elementary school dare. Hopefully you’ve done well with it. Do you have eosinophilic esophagitis?

[@KellyMartin-v8h]

No, I was given the gear from my doctor. A dialator along with some spray. It wasn't some dare. I'm 47 now and don't have much trouble swallowing.

[@Noitisnt-ns7mo]

After thousands of dollars, they gave me nothing. But they are getting wealthy, so it's not a total loss.

[@therealgeoff]

Is this guy for real? He seems very excited about the prospect of a patient shoving a tube down their throat as if it is some medical breakthrough. No thanks!

[@MarkCooperMD]

If you see people suffer and know there’s a way to help then and that’s your work, then yes, you get excited. It’s a blessing to find joy and meaning in one’s work.