Empiric Esophageal Dilatation for Solid-Food Dysphagia: Presence of Mucosal Tear on Relook Endoscopy Predicts Symptomatic Response

Rachael Jacob; Mark Danta; Robert Feller; David Williams; Santosh Sanagapalli

doi:10.14309/ajg.0000000000002319

Empiric Esophageal Dilatation for Solid-Food Dysphagia: Presence of Mucosal Tear on Relook Endoscopy Predicts Symptomatic Response

Am J Gastroenterol. 2023 Oct 1;118(10):1888-1890. doi: 10.14309/ajg.0000000000002319. Epub 2023 May 12.

Authors

Rachael Jacob^{1

2}, Mark Danta^{1

2}, Robert Feller^{1

2}, David Williams^{1

2}, Santosh Sanagapalli^{1

2}

Affiliations

¹ Department of Gastroenterology, St Vincent's Hospital, New South Wales, Australia.
² School of Clinical Medicine, St Vincent's Healthcare Campus, University of New South Wales, Australia.

PMID: 37170967
DOI: 10.14309/ajg.0000000000002319

Abstract

We hypothesized that a mucosal tear on relook endoscopy after empiric dilatation predicts symptomatic response. We evaluated symptomatic response (modified Ogilvie dysphagia score) after 161 consecutive esophageal dilatations. Comparing visible strictures, empiric dilatations with mucosal tear, and empiric dilatations without tear, baseline dysphagia scores were similar ( P = 0.34). Successful symptomatic response to dilatation occurred in 82% of visible strictures, 80% of those with tear, compared to only 37% of those with no tear ( P < 0.001). Patients with a mucosal tear after empiric dilatation have a superior symptomatic response to those without, and comparable to patients with visible strictures. We infer the tear represents disruption of an endoscopically inapparent stricture.