Graded pneumatic dilation using Rigiflex achalasia dilators in patients with primary esophageal achalasia

Am J Gastroenterol. 1993 Jan;88(1):34-8.


Pneumatic dilation is the initial therapy for primary esophageal achalasia. Recently, polyethylene balloon (Rigiflex) dilators have been used with varying success and complication rate. We performed a total of 47 dilations in 29 consecutive patients with achalasia using the Rigiflex dilators. The 3.0-cm balloon was always used first. If there was no symptomatic response, a 3.5-cm balloon was used after 4-8 wk. If there was still no symptomatic response after 4-8 wk, a 4.0-cm dilator was used. Eighteen (62%) patients were successfully dilated with a 3.0-cm balloon only. Of 11 patients not responding to a 3.0-cm balloon, five were dilated successfully with a 3.5-cm balloon. Of six patients not responding to a 3.5-cm balloon, four were successfully dilated with a 4.0-cm balloon dilator. Two patients eventually required surgery. The overall success with Rigiflex balloon dilator was achieved in 27 of 29 (93%) patients. There were no complications. We conclude that pneumatic dilation for esophageal achalasia performed in a graded fashion starting with Rigiflex 3.0-cm balloon dilator has a high success rate without complications in patients with achalasia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization / adverse effects
  • Catheterization / instrumentation*
  • Catheterization / methods
  • Chest Pain / etiology
  • Child
  • Esophageal Achalasia / physiopathology
  • Esophageal Achalasia / therapy*
  • Esophagogastric Junction / physiopathology
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Pressure
  • Treatment Outcome