Pneumatic Balloon Dilation of Achalasia


  • During an outpatient upper endoscopy, the endoscopist passes a catheter with a deflated balloon through the mouth and into the stomach.
  • The balloon is centered over the lower esophageal sphincter and inflated with air.
  • The pneumatic dilating balloon used to treat achalasia is 3 to 4 cm in diameter.
  • The standard dilator used to treat other causes of difficulty swallowing has a maximum diameter of 2 cm.
  • If symptoms do not improve adequately with the first dilation, a second or third procedure may be performed at a later date with a larger dilator.
  • Pneumatic dilation is often performed with X-ray guidance, although it can be performed using EndoFLIP, without X-ray guidance.

  • Patients with difficulty swallowing due to achalasia may be treated with pneumatic dilation.

Alternative treatments include per-oral endoscopic myotomy (POEM), Heller myotomy (a traditional surgery), and botulinum toxin (Botox) injection.

  • Pneumatic dilation is generally a safe procedure. Rare complications include bleeding and a puncture (or perforation) in the lining of the esophagus. If patient notice blood in the stool, black stool, fever, chills, vomiting, chest pain, stomach pain, or shortness of breath, doctor has to be contacted immediately.


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