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esophagus dialation (throat stretching)

greg from pa
Posts: 86
Joined: Jun 2010

Hi everyone, I am almost 4 months post treatment and still losing weight. Most solid food is rough to get down, I rely on liquid by mouth and small quantities of soft food for nourishment.I dropped from 180# down to 138# and can't seem to gain any. My ENT suggested throat stretching,has anyone had any experience with this procedure? What was it like? Did it help? I thougt he was trying to be a comedian at first! It sounds strange. Greg

micktissue's picture
micktissue
Posts: 432
Joined: Dec 2009

Joe (soccerfreaks) has had several dilations and I've had two. i think Dawn (Sweetblood) has had at least one. I'm sure there are others. My esophagus was completely closed (nothing would go down nor could I burp). They first had to tear through the scar tissue and that procedure was the worst. They have to intubate (not always I am told) and then pass either metal or plastic endoscopes down the throat to widen it. Just getting the devices down there tears the back of the throat up, so healing took me about a week before I knew how much it had changed.

The result was I could immediately swallow (water for the first time since May). When the throat healed form the procedure I moved onto other (softer)foods. While I could swallow food was becoming stuck due to the loss of suppleness of the esophageal tissues and muscles (mainly due to radiation) so they decided to do it again a month later.

The second procedure was like the first but there was less throat damage. Now food is going down like butter. I would definitely recommend it.

Best,

Mick

Hondo's picture
Hondo
Posts: 5887
Joined: Apr 2009

I go to see my new ENT again on the 29th, the first time he saw me was a week ago for all the pain in the head problems, and that is getting better. He can’t believe none of the other ENT’s I had never offer to do a dilation to help me with swallowing. I believe I have a good ENT now after 4 tries just worried about doing this with all my Jaw problems and if the things gets stuck how will they get it out, remember my Jaw only opens ½ inch.

Guess I will get all the answers on the 29th

Take care my friend

sweetblood22's picture
sweetblood22
Posts: 3230
Joined: Jan 2010

I have actually had three of them. One before cancer and two since radiation. I can eat a little better, but I still have a fairly bad stricture. I have been improving last few months, thank God. I was done with rads 5/15/09 and the first dialation was in October 09. The second was in January 2010. I should have another but I'm too scared because I have to be put on a ventilator and my mouth doesn't open and I had some issues unique to me that was very problematic and I'm too scared to go again. When I spoke about it to my one gastro doc I told her I was too scared to go again, my doc said, "I don't blame you, it got pretty hairy in there, we almost lost you." I am not willing to brave the general anesthesia again because of my unique issues. Want to make it clear that it's just me. The first time I had it done pre cancer it was easy peasy. They also can go up thru your Peg tube if you have one in. They may have to do it in stages. The first time after rads they stretched me from 2mm to 9mm and I could only get down liquids and yogurt. The next time I'm not sure what he took me to but I could eat very soft like mashed potato, bananas, cereal (some) oatmeal and that type of stuff. Been very slowly improving. Still not eating totally normal, but this I can live with.

Yep, it should fix you up. :) I had my peg for 18 months was glad to get rid of that thing!! But I needed it. I was down to 87 lbs. I am up to 101 now. I was 130 going into rads. Once you can swallow good substantial food it really makes such a difference, at least it did for me. Good luck!

Oh, and Hondo, keep me posted about what they say, because one of my major issues it they can't open my mouth enough and it's hard to get in there to intubate me and get the dialation done. I can get just about two of my fingers in my mouth, which is wider than yours. :( Hope they can do it for you.

greg from pa
Posts: 86
Joined: Jun 2010

Thanks to all who have replied with their wealth of experience and information. I'm gettin it done on tuesday! doc says I may be able to eat some of everything at the Christmas day dinner table! Greg

sweetblood22's picture
sweetblood22
Posts: 3230
Joined: Jan 2010

That's great! Hope you can eat something for Christmas. :)

neni01
Posts: 1
Joined: Mar 2014

I got dilated twice.. Once 20mm and second time to 24mm I don't see why the symptoms of food left overs still stick to my throat .  I chew well and take small bites... I am very frustrated makes me not want to eat and stick to ensures :( . anyone any advice?

CivilMatt's picture
CivilMatt
Posts: 3067
Joined: May 2012

neni01,

Welcome to the H&N forum, where even with no throat dilation or trouble swallowing, I still have to be careful on eating and swallowing.

I might suggest you start a new thread with your post, these older ones may not give you the answers you deserve (people see the date and pass it over).

Throat dilation has been an active topic of late and your question should generate a response.

Matt

Pam M's picture
Pam M
Posts: 2194
Joined: Nov 2009

My GI doc said he'd have a look, and if needed, give me a stretch when he removed my PEG. I was sore, but not in pain afterward, and couple days later, could swallow better. Good luck

DrMary's picture
DrMary
Posts: 527
Joined: Nov 2010

We haven't been to the dilation stage (only a few weeks post-treatment now) so I can't comment on that. Doug lost 35 lbs (from 175 to 140) in about 3 weeks, so gaining weight has been a priority. It sounds like you don't have a PEG (Doug doesn't either) - I won't recommend one, if you can swallow liquids.

We followed a refeeding protocol (they use it for anorexics and other folks who have starved and lost a significant amount of weight lately). The basics are that you want to make sure you are getting sufficient potassium, magnesium, and phosphorous (2700, 500, 1100 mg for your body weight is minimum and you can exceed that by 50% safely); you want to make sure you get enough protein (90 to 135 g) and you want to slowly increase your caloric intake by about 10% every few days until you get to a target (if you are not overly active, you should be able to gain 1 lb per week on 2300 calories).

We made it at first on those hated supplements - Boost Plus was our drug of choice. Five of those (1 cup per bottle) each day is 1800 calories, which is enough to maintain your weight. A few protein milkshakes (we do 1 cup of milk, 1 scoop of Bluebonnet whey isolate, 1/2 cup of Carbogain and 2 T vanilla syrup in the blender - 500 calories and very easy to swallow) makes up the rest and then any solid/soft food you squeeze in is extra. Folks have shared various recipes here, so I won't elaborate.

How many calories a day are you managing now?

abbimom's picture
abbimom
Posts: 81
Joined: Sep 2010

I had cancer 10 years ago and since then I've had 2 throat dilations. they help a lot. After the surgery your throat feels sore for about 3 days but that is that. With any surgery there are risks and the one risk with this one is that they could tear a hole in your esophagus. Even with that risk I would do the throat dilation again. There was a huge difference in what I could afterwards. Only downside is that I gained weight pretty fast. Hope this helps.
Best wishes,
Linda

kimmygarland's picture
kimmygarland
Posts: 313
Joined: Aug 2009

So glad to see this post... my husband will hopefully be having one after first of year. He can't even swallow his own spit so hoping it will help. His ENT surgeon says he will do the first one, and then have GI do any subsequent that might be needed.

Maxs gramma
Posts: 3
Joined: Oct 2010

My husband also cannot swallow ANYTHING. We just had a swallow test done on Monday and nothing is getting thru. He finished all treatment on October 25. We are to see the gastro doctor on Jan 12 and hoping for good news. He has had 2 dialations done in the past for strictures further down before he was found to have cancer. It just seems as if it never ends. Glad to see people have had positive outcomes.

MJ70
Posts: 65
Joined: Nov 2010

Greg: I have had two in the last seven years..both in the last two years..They tell me most of the Head and Neck cancer patients will get these pretty regular plus all the exercises to go with it.. Some do it every six months...Mine have been under the gas in the OR but they say it can be done in the office ...Depending on the patients tolerance...I might try it next time that way as it does help ...... Good luck..

.Mel

dennis318's picture
dennis318
Posts: 349
Joined: Feb 2010

I'm going back to Doctor end of this month, we may try to surgically tie, or trim my paralyzed larnxz back, I figured teh 2nd doctor out of 4 screwed it up, it can't get much worst, i caught a chest cold, very dry, nothing comes up and my breathing os hard, probably inflamed again fron rads, how far to they go down your dthroat to dialte or stretch, evidently my doc doesn't think this is an answer, the option of either t********, will eighter drown my lungs, or I will total voice, what a choice..Dennis, Hope all Is well In the Cancer Fight Here...

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