• Reference Number: HEY-220/2018
  • Departments: Endoscopy
  • Terminal Updated: 4 October 2018

Introduction

This leaflet has been produced to requite y'all general data about your procedure.  Virtually of your questions should have been answered past this leaflet.  It is not intended to replace the discussion betwixt yous and your medico, simply may human activity as a starting betoken for discussion.   If after reading information technology yous take any concerns or crave further explanation, delight discuss this with a member of the healthcare squad who has been caring for you.

Please DETACH THE INFORMATION CHECKLIST AND BRING Information technology WITH Y'all

What is Oesophageal Dilatation?

It is a procedure to widen the narrowing in your oesophagus. The first step is an endoscopy which you probably have experienced at an before date, but the procedure will take a few minutes longer as it is a piddling more an inspection. In most cases you lot will be given a sedative.

The doctor volition laissez passer a slim flexible tube with a light on into your gullet (oesophagus) until information technology reaches the narrowing. In some patients a balloon dilator is used which is inserted into your gullet to the bespeak of the narrowing and is then gently inflated to stretch your gullet. In other patients, a fine wire is passed through the endoscope into your breadbasket through the narrowing. The endoscope volition then exist removed leaving the wire in your gullet. The doctor will then pass the dilator over the wire and downwards to the narrowing. Business firm but gentle pressure is used to push button the dilator through the narrowing; this procedure is repeated using larger dilators until the narrowed area has been adequately stretched.  Occasionally an X-ray may exist required during the process. The procedure will take well-nigh 10 minutes.

Why Do I need Oesphageal Dilatation

You take probably been troubled by some symptoms, which have led to your md advising you lot to have handling called an oesophageal dilatation to stretch the narrowing (stricture) in your gullet (oesophagus).

This volition help relieve the swallowing difficulties you are experiencing. This process may have to be repeated periodically to enable food and fluids to pass through the gullet (oesophagus).

Tin can there be any complications or risks?

Perforation of the gullet

Oesophageal Dilatation carries a run a risk of perforation (hole) of the gullet. In nearly circumstances the take a chance is 1%, merely there are reports of the risk reaching 10%. If this occurs, you may experience a pain in your chest or back, exist brusque of jiff and feel mostly clammy and unwell.
If y'all accept whatever of these symptoms Y'all MUST CONTACT your doc or the hospital Endoscopy Department or Ward 100 HRI (out of hours) every bit soon as possible.

Sedation

Some people, for reasons we nonetheless do not fully understand, are specially sensitive to the allaying drug. The breathing tin can be too shallow and besides deadening. In these cases nosotros stop the test, give more than oxygen and if required nosotros can give an antidote to contrary the effect of the sedation. This is usually all that is needed and the person recovers with no sick or lasting effects.
In some cases, when people have another serious affliction e.g., centre disease, stroke, unstable angina, severe asthma or chronic bronchitis, the sedation drug can cause difficulty in breathing. This is rare and is why nosotros monitor breathing and heartbeat throughout; and why we give oxygen past nasal tubes.
Common problems, which are not serious, include a haematoma (large bruise from your sedation needle) a sore throat and bloating.

What if I turn down to have the Oesophageal Dilatation?

This will not alter the manner in which we treat you and your standard of care volition non alter. However, information technology will be an of import piece of data virtually your gastrointestinal tract that we volition non have and you will non get the relief of your swallowing trouble. Please discuss this with your doctor/specialist team.

Who will practice the procedure?

It will be a consultant or senior doctor who is trained and experienced in performing the procedure. Sometimes called an Endoscopist.

Where will the test be performed?

Oesophageal dilatation is generally performed in the Endoscopy Department. Especially trained doctors and nurses piece of work hither and are very experienced in performing oesophageal dilatation and in the care it involves.

It will be done at Hull Regal Hospital or Castle Loma Infirmary depending on where your consultant is based. Delight make certain you go to the correct Endoscopy Department. Directions will exist given with your engagement letter. All the staff volition assistance to brand your stay as easy and dignified every bit possible. Please do not be afraid to ask questions.

How do I set up for the process?

Please read the information leaflet. Share the information with your partner and family (if you lot wish) so that they can be of help and back up. There may be information they need to know, especially if they are taking care of you post-obit this exam. Complete the health questionnaire sent/given to you as fully as possible.

To allow for a clear view, your stomach and commencement part of your intestine needs to be empty.

You lot should not accept any thing to eat and potable for at least vi hours before your test. Do take any regular medicines upwardly to this point.

If you accept diabetes (especially taking insulin) or yous have serious heart, lung or kidney problems, or concerned that a wellness trouble yous have may exist affected, and then contact the endoscopy section at the infirmary yous are having your examination (see contact numbers).

Warfarin – These are blood thinning tablets and ordinarily have to be stopped for a period of time before your examination, delight contact your endoscopy department for advice.
Latex – Delight inform the department if you accept a confirmed latex allergy as this volition affect your engagement time.
Creutzfeldt-Jakob disease/variant Creutzfeldt-Jakob illness (CJD) commonly known as mad cow disease – Please inform the department if you have been notified that you are at run a risk of CJD/vCJD for public wellness reasons.
Clopidogrel (Plavix) – Delight inform the department if you are taking these tablets as these may need to be stopped prior to your procedure.
Pregnancy – It is important that y'all inform us if there is a possibility that you may be significant. Whatsoever information you lot share with u.s. will exist kept strictly confidential.

If you have any of the following blood thinning tablets please contact the Endoscopy Section earlier your appointment for farther advice: Apixaban, Rivaroxaban, Dabigatran, Dabigatran, Argatroban or Edoxaban.

What happens to me in the Endoscopy Department?

Our friendly reception staff will greet you lot on inflow. They will let a nurse know that you have arrived. Occasionally there may be a delay in your appointment time due to any emergency taking place. If there are whatsoever delays you will be notified as soon equally possible and exist kept informed.
A nurse volition collect you from the waiting room and explain what will happen next. You volition be given an approximate time of when you may be collected to become dwelling. It is appropriate to leave any valuables at home.

Nosotros will inquire you questions nearly your full general health and work through the health questionnaire you have completed for us. Delight feel costless to ask questions.

The endoscopist will meet yous and explicate the test to you. You volition both sign a consent course. This is to testify yous empathise what will happen and concord to the procedure being performed. At whatsoever point during the process you can withdraw your consent and ask for the procedure to finish. If this happens the endoscopist will terminate the test and accept the telescopic out. If yous have whatever queries or worries, please tell united states.

We will check your blood pressure, pulse, oxygen levels and weight, before your test.

If yous wear glasses or dentures, y'all volition exist asked to remove them. You will be taken to the examination room and made comfy on a bed on your left-hand side. To keep your mouth open, a plastic mouth guard will be placed between your teeth. A fine plastic tube will balance by your nostrils to give you some extra oxygen. A probe will exist placed on your finger to monitor your oxygen levels and pulse rate.

Do I need sedation?

Yes. People have sedation to go along them comfortable while the doctor carries out the procedure. Sedation is given through a flexible needle in the back of your hand or arm. It makes y'all feel sleepy and relaxed but does not put you to sleep. You lot tin can still respond to what is happening.

Do I really need someone with me after sedation?

Yeah, this is very important. The sedation given can take effects, which can last up to 24 hours after the test. You can become forgetful and besides sleepy once more.

Your exam may be cancelled if you lot practise non arrange to have someone to collect you and stay with you for the adjacent 24 hours.
Nosotros strongly recommend that for the side by side 24 hours you:

  • Do not drive
  • Do not return to work or operate mechanism
  • Practice not sign whatever important/or legal documents
  • Are non left alone, you may exist at risk of injuring yourself
  • Are not left lone to care for children

If y'all are an outpatient, the person accompanying y'all will exist contacted to collect you. If you lot are an inpatient you will be transferred back to your ward.

What happens when the test is finished?

You will need to residue on a trolley in the recovery room. We will cheque your claret pressure level, pulse and temperature on a regular ground. Y'all will need to stay in the department longer after this procedure then we tin can monitor you closely, you will then exist helped to a chair and given a beverage. Your relative or friend volition then be contacted to collect you. It is quite likely that the dorsum of your pharynx will experience sore for the rest of the day.

You may feel swollen if some air remains in your tummy. Both discomforts usually pass without whatsoever medication. Your swallowing may not appear to be improved or may seem worse for one-2 days owing to the swelling of the tissues. Yous may find you have some streaks of claret in your saliva after the process this is quite normal and should end without whatever further handling.

When exercise I get the results?

The Recovery nurse volition explain your results to you and (if yous wish) the results will be told to your carer. They will be written on your discharge class with any instructions that you need to follow. If yous wish, the nurse will repeat the result to y'all before you leave the department. Your own doctor or hospital doctor will receive a copy of the results.

Will I ever need an Oesophageal Dilatation again?

Yep, it is possible this procedure may have to be repeated periodically to enable nutrient to laissez passer down your gullet to your tummy.

If y'all have whatsoever further swallowing issues you tin can contact your Endoscopy Section directly for advice.

Farther information

If you crave further data most your test your GP, your Consultant, and the Endoscopy Department is a valuable source of information. Further information almost your rights with regards to consent can be establish in the following documents:

  • Department of Wellness (2001), Guide to Consent for Examination or Handling.
  • Department of Health (2001), Consent – What y'all have a right to expect.
  • A Guide for Adults. (Bachelor from the Endoscopy Department)
  • A Guide for Relatives and Carers. (Available from the Endoscopy Department)

These are gratuitous of accuse.
Visit the Section of Health'due south website at: world wide web.doh.gov.uk and, for consent: www.doh.gov.uk/consent
Useful contact numbers:
The Endoscopy Department, Castle Hill Hospital Tel: (01482) 622069 Mon – Friday: 8am – 5pm
The Endoscopy Department, Hull Imperial Infirmary Tel: (01482) 674790 Mon – Fri: 8am – 5pm
Ward 100 Hull Royal Hospital Out of hours (01482) 675100

What practice the words in the leaflet hateful?

Biopsy – A sample of tissue is taken for analysis.
Consent – This is the agreement between yous and the endoscopist. Yous are agreeing to have investigations or treatment and that yous understand the purpose, benefits, alternatives and risks. Yous and the endoscopist during this procedure usually sign a consent form.
Endoscopy – Inspection of your tummy with a flexible camera.
Endoscopy Section – The place where your procedure takes place.
Endoscope – A tube for looking inside the body.

Endoscopist – This can either be your consultant, an experienced and trained doctor or an experienced and specially trained practitioner.
Oesophageal Dilatation – Stretching of the gullet to alleviate bug of swallowing.

This leaflet has been written with the assistance, support, advice and collaboration of:

  • Consultants of the Section of Gastroenterology
  • Consultants of the Surgical Department
  • Staff of the Endoscopy Department
  • Patients attending the Endoscopy Department

Full general Communication and Consent

Well-nigh of your questions should have been answered by this leaflet, but recall that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doc, nurse or therapist examines or treats you, they must seek your consent or permission. In guild to make a decision, you lot need to have information from health professionals almost the treatment or investigation which is being offered to you. You should e'er ask them more questions if you do non understand or if y'all want more than information.

The information you receive should be almost your condition, the alternatives available to you lot, and whether it carries risks as well as the benefits. What is of import is that your consent is genuine or valid. That means:

  • yous must be able to give your consent
  • you must be given plenty information to enable you to brand a decision
  • you must be acting nether your ain free will and not under the strong influence of some other person

Data well-nigh you

Nosotros collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare squad, some of whom you may not meet. Your information may likewise be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with inquiry. Wherever possible we use anonymous data.

Nosotros may pass on relevant data to other wellness organisations that provide you with care. All data is treated equally strictly confidential and is non given to anyone who does non need information technology. If you have whatsoever concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of whatever information we hold well-nigh you. For further information visit the post-obit folio: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a dissimilar format, such every bit large print, braille or audio, due to inability, impairment or sensory loss, please advise a member of staff and this tin exist arranged.

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