1. What is the medical evidence for endoscopic dilation?
According to a meta-analysis of nine studies with a total of 525 subjects and 992 dilations, endoscopic dilation can improve EoE patients’ symptoms in 75% of cases. As to be expected, however, dilation has no effect on the underlying oesophageal inflammation. The duration of symptom improvement varied greatly in this analysis.1 Endoscopic dilation is considered to be a safe procedure, with the rates of clinically relevant complications such as perforation or bleeding being reported as less than 1%.2 While 74% of patients reported chest pain immediately after the intervention,3 only 2% still complained of this symptom at discharge.1 Another recent meta-analysis evaluating 37 studies with a total of 977 patients and 2,034 dilations reached similar conclusions (see table 5).4
Table 5: Endoscopic dilation in EoE. Adapted from Dougherty M et al. Gastrointest Endosc 2017.4
*Confidence interval.
2. References
Moawad FJ, Cheatham JG, DeZee KJ. Meta-analysis: the safety and efficacy of dilation in eosinophilic ooesophagitis. Aliment Pharmacol Ther 2013; 38(7):713–20.
Jung KW, Gundersen N, Kopacova J, Arora AS, Romero Y, Katzka D et al. Occurrence of and risk factors for complications after endoscopic dilation in eosinophilic oesophagitis. Gastrointest Endosc 2011; 73(1):15–21.
Schoepfer AM, Gonsalves N, Bussmann C, Conus S, Simon HU, Straumann A et al. Esophageal dilation in eosinophilic oesophagitis: effectiveness, safety, and impact on the underlying inflammation. Am J Gastroenterol 2010; 105(5):1062–70.
Dougherty M, Runge TM, Eluri S, Dellon ES. Esophageal dilation with either bougie or balloon technique as a treatment for eosinophilic oesophagitis: a systematic review and meta-analysis. Gastrointest Endosc 2017; 86(4):581–91.e3.
