Endoscopic Dilation of a Sleeve or Anastomotic Stricture

For most people, healing after weight-loss surgery is smooth. But every so often, something shifts. Swallowing feels different. Liquids go down, but a few bites of solid food seem to catch and sit. You may feel nausea, chest pressure, or the need to bring food back up. It's frustrating, and it can be worrying — you did everything right, and now eating feels hard again.

This can happen when a small area of your new anatomy narrows: the connection (anastomosis) after a gastric bypass, or a tight spot along the pouch after a sleeve gastrectomy. We call this a stricture, and it is a known, treatable part of recovery — not a sign that your surgery failed or that you did something wrong. Endoscopic dilation is how we gently reopen that narrowed area and get you back to eating comfortably.

This is a same-day, incision-free procedure done through an upper endoscopy — the same gentle approach used for a comprehensive EGD. You'll be comfortably sedated, and we pass a slim, flexible camera through your mouth and down into the stomach so we can see the narrowed area clearly on screen.

Once we find the tight spot, we ease a small balloon across it and slowly inflate it, stretching the narrowing open a little at a time. In some cases we use a graduated dilator instead. The goal is a controlled, gradual widening — enough to relieve your symptoms while protecting the surrounding tissue. The whole thing usually takes just a few minutes once you're settled, and there are no cuts and no stitches.

Preparation is simple. We'll ask you to stop eating and drinking for several hours beforehand so your stomach is empty and the sedation is safe — we'll give you exact timing. Because you'll be sedated, you'll need a trusted person to drive you home and stay with you for the rest of the day.

Let us know about every medication you take, especially blood thinners, and about any allergies. If you're managing conditions like type 2 diabetes, we'll walk through how to adjust your medications for the fasting window. Come with your questions written down — we want you to feel informed and calm walking in.

Most people go home within a couple of hours, once the sedation wears off. A mildly sore throat or a little bloating for a day is common and fades quickly. We'll guide you to start with liquids and then step back up to your regular post-surgery diet over the next day or two.

Many people notice relief almost right away. Sometimes a stricture needs to be stretched in stages, over two or three short sessions spaced a couple of weeks apart, so the tissue relaxes gradually and comfortably. That's a normal, expected path — not a setback. If narrowing keeps returning despite dilation, we'll talk together about other options, including revisional surgery, though most strictures resolve well with dilation alone.

Let's start with what matters most: this works. Endoscopic dilation relieves symptoms for the large majority of people, often restoring comfortable eating without ever needing another operation. It protects the results of your original procedure and gets you back to the progress you've worked so hard for.

It's also a very safe, well-established procedure — as routine as a standard diagnostic endoscopy, done thousands of times a day across the country. Because it's incision-free, recovery is quick and complications are uncommon. Serious risks like a tear in the stomach wall are rare, and doing the stretching gradually is exactly how we keep them rare. We'll always be direct with you about what we see and what comes next.