Concierge gastroenterology · UK
Private oesophageal dilatation, by a consultant gastroenterologist.
A safe day-case endoscopic procedure to widen a narrowed oesophagus - bougie, balloon or pneumatic, chosen for your stricture, delivered in a BSG-standard unit with surgical backup on call.
Why patients choose us
- 01
A consultant gastroenterologist, in a proper endoscopy suite
Not a training list. A named gastroenterologist experienced in dilatation, working in a BSG-standard endoscopy unit with fluoroscopy on hand where needed.
- 02
The right technique for the stricture
Bougie or through-the-scope balloon - chosen for the aetiology and anatomy of your narrowing, not by whichever kit is on the trolley.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private oesophageal dilatation costs in the UK.
Indicative ranges across our partner clinics. Dilatation is also NHS-funded via gastroenterology. Send the details and we quote firm figures.
In short
A private OGD with dilatation in our network: £2,000–£3,800, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| OGD with bougie dilatation | £2,000–£3,500 | 15–30 min | Same visit |
| OGD with balloon (TTS) dilatation | £2,200–£3,800 | 15–30 min | Same visit |
| Pneumatic dilatation for achalasia | £3,000–£4,500 | 30–45 min | Same visit |
| Dilatation with fluoroscopic guidance | £2,500–£4,000 | 30 min | Same visit |
| Self-expanding metal stent (malignant) | £3,500–£5,500 | 30–45 min | Same visit |
| Gastroenterology consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which gastroenterologist does the case, and by whether fluoroscopy or a stent is needed. Dilatation is available NHS-funded via gastroenterology if you prefer. We come back with a firm quote within one working day.
The problem
The right technique, in the right unit, by the right hands.
Dilatation is safe when done well and risky when it is not. The three things that matter - technique choice, endoscopy unit standards, and surgical backup - get quietly cut in some private lists. We do not.
-
Food sticking - is it a stricture?
Reflux, EoE, cancer, achalasia and rings all cause dysphagia. A proper OGD sorts them before you agree to dilatation.
-
Worried about perforation?
Small but real. A gastroenterologist experienced in dilatation, in a unit with surgical backup, is how you keep the risk where it belongs.
-
Told to accept repeat sessions?
A serial programme is often the right plan - but sometimes surgery or a stent is a better long-term answer. We tell you honestly.
The journey
From enquiry to recovery - what happens, in order.
One clinician from first message to review - including the recovery window and any planned repeat.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the unit
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Swallowing difficulty, food sticking, weight loss, prior surgery or radiotherapy, any known stricture.
- 02
Before
We come back with a recommendation
Within one working day: the right gastroenterologist, the right technique (bougie vs balloon vs pneumatic), an indicative price. If a different test is needed first, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Blood thinners are reviewed with the team and you are told exactly how to fast - six hours for solids, two for clear fluids.
- 04
On the day
Arrival at the endoscopy unit
Arrival, consent and a chat with the gastroenterologist and sedation nurse. Conscious sedation (midazolam and fentanyl) is standard; GA for pneumatic dilatation or complex cases.
- 05
On the day
The procedure itself
15 to 30 minutes. OGD identifies the stricture, a guidewire is passed, and the dilator - bougie or balloon - is placed and held to the target diameter.
- 06
On the day
Home the same day
A short recovery on the unit, written aftercare, and home within a few hours. You will need someone to collect you after sedation.
- 07
After
Recovery and review
Mild chest discomfort settles within a day or two. Symptom review at two to four weeks - many benign strictures need a further session to hold the diameter.
Typical end-to-end: 1–2 weeks from enquiry to procedure. Symptom review: 2–4 weeks.
When it helps
When oesophageal dilatation is the right step.
The stricture types we see most, and where dilatation is a bridge rather than the definitive answer.
-
Peptic stricture
Scarring from severe reflux or Barrett’s oesophagus - the commonest benign indication and the most responsive to dilatation.
-
Anastomotic stricture
After oesophagectomy or fundoplication - see /treatments/oesophagectomy. Often needs serial dilatations.
-
Post-radiation stricture
After radiotherapy for oesophageal or head and neck cancer. Fibrotic, sometimes long - usually managed with balloon dilatation.
-
Caustic ingestion stricture
After ingestion of acid or alkali. Complex, often long-segment - a specialist decision on technique.
-
Eosinophilic oesophagitis (EoE)
Fibrostenotic EoE - dilatation alongside a proton pump inhibitor, topical steroid or dietary elimination.
-
Achalasia (pneumatic dilatation)
A larger 30–40 mm balloon stretches the lower oesophageal sphincter. See /treatments/laparoscopic-achalasia-surgery for the Heller alternative.
-
Schatzki ring
A thin mucosal ring at the lower oesophagus - a single dilatation usually resolves food sticking.
-
Malignant stricture - stent, not just dilate
Advanced oesophageal or gastric cardia cancer is better palliated with a self-expanding metal stent for longer-term patency.
Technique options
Bougie, balloon, pneumatic - chosen for the stricture.
What each technique actually involves, and which stricture it suits.
-
Bougie dilatation (Savary-Gilliard)
Semi-flexible dilators of increasing diameter passed over a guidewire. Tactile feedback - the workhorse for benign fibrous strictures.
-
Balloon dilatation (TTS, CRE)
Through-the-scope Controlled Radial Expansion balloons. Controlled fluid pressure, multi-stage - suits a wider variety of strictures.
-
Over-the-guidewire balloon
Balloon passed alongside or over a guidewire, often under fluoroscopy for tight or angulated strictures.
-
Pneumatic dilatation (Rigiflex)
A 30–40 mm balloon at the lower oesophageal sphincter for achalasia. Often needs two or three sessions.
-
Serial dilatation programme
Planned repeat sessions at set intervals for recurrent benign strictures - steadier than emergency top-ups.
-
Self-expanding metal stent (SEMS)
For malignant strictures - palliative, provides longer-term patency and better swallowing than repeat dilatation.
-
Adjuncts: steroid injection, incisional therapy
For refractory anastomotic or fibrotic strictures - used in specialist units alongside dilatation.
-
Consultation only
An honest discussion of whether dilatation is the right next step, or whether more imaging or a different treatment fits - no obligation.
Our vetted UK network
A small panel of gastroenterologists, we picked them.
Consultant gastroenterologists across the UK who do dilatation regularly, working in JAG-accredited endoscopy units. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every gastroenterologist in our network.
-
Consultant gastroenterologists with a stricture and dilatation workload
-
BSG-standard endoscopy units with fluoroscopy available
-
Anaesthetic support for pneumatic dilatation and complex cases
-
Clear pathway for surgical or interventional backup if perforation occurs
Safety and recovery
What to expect - honestly.
Dilatation is a safe outpatient endoscopic procedure with excellent initial symptom relief. Perforation is the risk that matters - small but significant, and the reason a proper unit and informed consent are non-negotiable.
-
Perforation is the main serious risk
Overall 0.5–3%, depending on aetiology and technique. Highest for pneumatic dilatation of achalasia (2–6%); peptic stricture is under 1%. If it happens, urgent clip closure, stenting or surgery.
-
The rule of threes
No more than three dilators exceeding the stricture waist in a single session. Steady widening across sessions is safer than forcing the diameter in one go.
-
Bleeding is usually minor
A little oozing from the mucosa is common. Significant bleeding is rare and the endoscopist is set up to control it.
-
Chest pain is common and transient
A dull retrosternal ache for a day or two is expected. Severe or persistent pain, fever or breathlessness is not - call the unit.
-
Aspiration during sedation
Airway protection with proper fasting and positioning keeps this rare. It is why the six-hour fast matters.
-
Bacteraemia - prophylaxis in high-risk
A transient bacteraemia can occur. Antibiotic prophylaxis is considered for prosthetic valves and other high-risk cardiac conditions.
-
Recurrence is the main long-term issue
Benign strictures recur in around 20–30% and may need a serial programme, or eventually surgery or stenting.
-
Informed consent matters here
The perforation risk is small but real. A proper consent conversation - what could happen and what the backup is - is not optional.
-
Red flags after the procedure
Fever, severe chest or back pain, breathlessness, surgical emphysema (crackling under the skin of the neck) or vomiting blood - same-day A&E.
Reading your endoscopy note
Your endoscopy note in four parts. Read the last one first.
Whichever technique was used, the note the gastroenterologist sends you keeps to the same shape.
A quiet reminder
Endoscopy language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and stricture location
Why the procedure was done - peptic, anastomotic, radiation, EoE, achalasia - and where in the oesophagus the narrowing sat.
- 02 Technique
Dilator type and diameters achieved
Bougie or balloon, guidewire and fluoroscopy use, the starting waist diameter and the final diameter reached this session.
- 03 Findings
Mucosa, biopsies and any incidental notes
Appearance of the stricture, any biopsies taken, and incidental findings - Barrett’s, oesophagitis, hiatus hernia, candidiasis.
- 04 Impression
Plan, repeat interval, medication
Read this first: whether a repeat dilatation is planned and when, what proton pump inhibitor or steroid to continue, and when to be reviewed.
Recognised by major UK insurers
Oesophageal dilatation is usually covered by private medical insurance when medically indicated. We confirm cover before booking.
Frequently asked
Everything we get asked about oesophageal dilatation.
Quick answers on technique, pain, cost, perforation risk, repeat sessions and alternatives.
-
What is an oesophageal dilatation?
An endoscopic procedure - done during an OGD (gastroscopy) - that widens a narrowed segment of oesophagus. A bougie or balloon dilator is passed to the stricture and held at a target diameter to stretch the scar tissue.
-
Why might I need one?
The commonest reasons are a peptic stricture from severe reflux, an anastomotic stricture after oesophagectomy or fundoplication, a post-radiotherapy stricture, eosinophilic oesophagitis, a Schatzki ring, or achalasia (pneumatic dilatation). We match the technique to the cause.
-
Bougie or balloon - which is better?
Neither is universally better. Bougie dilators give tactile feedback and are the workhorse for benign fibrous strictures. Through-the-scope balloons (CRE) give controlled radial expansion under vision. The gastroenterologist chooses based on the stricture, not preference.
-
Does it hurt?
You are sedated for the procedure and feel little at the time. Afterwards a dull retrosternal chest ache for a day or two is common. Severe pain, fever or breathlessness is not normal - call the unit or A&E.
-
How much does a private oesophageal dilatation cost in the UK?
Roughly £2,000–£3,500 for bougie dilatation, £2,200–£3,800 for balloon, and £3,000–£4,500 for pneumatic dilatation of achalasia. A self-expanding metal stent for malignant stricture is £3,500–£5,500. NHS-funded dilatation is available via gastroenterology.
-
What is the risk of perforation?
Around 0.5–3% overall, depending on the aetiology and technique. Peptic stricture is under 1%; pneumatic dilatation of achalasia is 2–6%. If it happens, endoscopic clip closure, stent placement or surgery is arranged urgently - which is why we insist on a unit with that backup.
-
Will I need repeat sessions?
Often, yes. Peptic strictures recur in 20–30% and may need a repeat. Anastomotic and radiation strictures often need serial dilatations. Achalasia pneumatic dilatation frequently needs two or three sessions to hold symptom relief.
-
What are the alternatives?
For achalasia, laparoscopic Heller myotomy is a durable surgical alternative - see /treatments/laparoscopic-achalasia-surgery. For malignant strictures, a self-expanding metal stent gives longer-term relief. For EoE, medical management with a PPI, topical steroid or dietary elimination is often the priority.
Related treatments
Looking for something else?
-
Oesophagectomy
Surgical removal of the oesophagus for cancer or refractory disease.
Learn more -
Laparoscopic achalasia surgery
Heller myotomy - a durable surgical alternative to pneumatic dilatation.
Learn more -
Endoscopic mucosal resection
Removal of early oesophageal or gastric lesions at endoscopy.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more