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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.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private oesophageal dilatation costs in the UK.

Indicative ranges across UK private providers. Dilatation is also NHS-funded via gastroenterology.

In short

£2,000–£3,800, home the same day.

Procedure Indicative range
OGD with bougie dilatation £2,000–£3,500
OGD with balloon (TTS) dilatation £2,200–£3,800
Pneumatic dilatation for achalasia £3,000–£4,500
Dilatation with fluoroscopic guidance £2,500–£4,000
Self-expanding metal stent (malignant) £3,500–£5,500
Gastroenterology consultation only £200–£400

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.

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.

  • 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. Honest advice includes saying so.

When it helps

When oesophageal dilatation is the right step.

The stricture types most often seen, 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

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 UK consultant gastroenterologist reviewing a patient’s endoscopy notes

A quiet reminder

Endoscopy language is precise and can read coldly - ask your care team to explain anything that is unclear.

If you would like someone to talk you through the note before your review, ask the clinician who wrote it.

  1. 01 Header

    Indication and stricture location

    Why the procedure was done - peptic, anastomotic, radiation, EoE, achalasia - and where in the oesophagus the narrowing sat.

  2. 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.

  3. 03 Findings

    Mucosa, biopsies and any incidental notes

    Appearance of the stricture, any biopsies taken, and incidental findings - Barrett’s, oesophagitis, hiatus hernia, candidiasis.

  4. 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

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Oesophageal dilatation is usually covered by private medical insurance when medically indicated.

Frequently asked

Common questions 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).

  • 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 a unit with that backup matters.

  • 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.

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