The Complications of Endoscopy with Balloon Dilation: What Patients Should Know

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Endoscopy and Balloon Dilation

Endoscopy is a procedure involving the use of an endoscope to examine visually the inside of a body. Balloon dilation involves using a balloon dilator with an endoscope. The balloon may be injected with water, saline or another liquid in order for expansion.

According to Boston Scientific, balloon dilation presents some advantages, such as “direct endoscopic visualization, application of radial force directly to the stricture site and improved patient comfort.”

Balloon dilators come in various diameters and the balloons used in endoscopic procedures may be filled with different levels of pressure, though 15psi is reported to be the maximum pressure that should be used if a lower risk of complications is desired. In some cases, a psi of 11 or less is recommended for optimum results with the lowest risk factor.

Research of Complications

In a study of forty patients who received endoscopic balloon dilation, 28 developed symptoms that recurred. Twelve of these patients did require surgery at a later date.

According to a review published in Digestive Diseases and Sciences regarding this study, a repeat of the endoscopic procedure is often needed in order to achieve long-term success for the patient.

The American Society for Gastrointestinal Endoscopy cites a 1974 study in which the complications rate for 200,000 patients was 0.13%, with a mortality rate of 0.004%. This statement notes that complications of endoscopy are understudied and more current, accurate data is needed.

A few of the reported complications related to endoscopy with balloon dilation are listed below.

Endoscopy with Balloon Dilation Complications

  • Infection. As with any invasive medical procedure (even one that is minimally invasice), infection is always a risk.
  • Achalasia. Spasms of the lower esophagus can occur. The use of lower inflation pressures can help avoid this complication and others.
  • Perforation. Though the risk for this complication is very low (up to 6.7%), it is a possible complication.

Dealing with Complications

The risk for complications of endoscopy with balloon dilation can be influenced by various factors, including the amount of additional procedures being performed by the endoscopist on the patient.

It is important that patients immediately report any unusual symptoms or problems to their doctor so potential problems from complications may be minimized. Symptoms can include bleeding, pain or discomfort and esophageal spasms.

Prevention

A patient scheduled to undergo an endoscopy with balloon dilation who is concerned about the risk of complications should discuss his or her concerns with the endoscopist prior to the day of the procedure. Any health problems or allergies the patient has should be revealed in full and in advance to help minimize risk of complications.

References

GI Dilation. Boston Scientific. https://www.bostonscientific.com/procedure/ProcedureLanding.bsci/,,/navRelId/1000.1002/method/Procedure/id/10000921/seo.serve

Long-Term Results of Endoscopic Balloon Dilation for Gastric Outlet Obstruction. James J. Boylan and Malgorzata I. Gradzka. Digestive Disease and Sciences (Journal). Vol 44, Num9. September 1999. https://www.springerlink.com/content/r708020356h13054/

Complications of Upper GI Endoscopy. American Society for Gastrointestinal Endoscopy. (pdf) https://www.asge.org/WorkArea/downloadasset.aspx?id=3320&LangType=1033