Oesophageal stent insertion

Your doctor has requested that you have an oesophageal stent inserted. We hope the following information will answer some of the questions you may have about this procedure.

What is oesophageal stent insertion?

The oesophagus, or gullet, is a hollow, muscular tube which takes food from the mouth down to the stomach. If it becomes blocked or narrowed, then there will be a problem with swallowing. 

One way of overcoming this problem is by inserting a metal, mesh tube, called a stent, down the oesophagus and across the blockage or narrowing. Food can then pass down the gullet through this stent, and this should make swallowing easier. This procedure is called oesophageal stent insertion, and is usually very helpful to people.

Why do I need an oesophageal stent insertion?

Other tests that you probably have had done, either an endoscopy (telescope test) or a barium swallow, have shown that your oesophagus has become blocked or narrowed. Your doctor will have discussed with you the likeliest cause for this and the possible treatments. It is likely that an operation has been ruled out, and that a stent insertion is considered the best treatment option for you.

Who has made the decision?

The doctors in charge of your case, and the consultant clinician performing the oesophageal stent insertion will have discussed the situation, and feel this is the best treatment. However, your opinion to be taken into account, and if, after discussion with your doctors, you do not want the procedure carried out, then you can decide against it.

Who will be doing the oesophageal stent insertion?

A specially trained Radiologist or Gastroenterologist who are both doctors with special expertise in using X-ray equipment, and in reading the images produced. They need to look at these images while carrying out the procedure, to make sure that the stent is positioned correctly.

How do I prepare for oesophageal stent insertion?

• The procedure uses X-rays and the amount of radiation used is small, however if you think you may be pregnant please inform the Imaging department before attending the appointment.
• You should eat nothing for 6 hours before your appointment. You may drink water until the time of your appointment.
• You will arrive at the Imaging department (Gate 19) and be accompanied into our day case area.
• You may take your normal medication unless instructed otherwise.
• Please inform us if you are allergic to anything.
• You will be asked to change into a hospital gown and a small plastic tube (cannula) may be put into your arm in case you need painkillers or sedatives during the procedure.
• A doctor will discuss the procedure with you. You will be given an opportunity to ask questions. If you want to go ahead with the procedure you will be asked to sign a consent form.
• Once all the checks have been performed and consent signed, you will be taken to the procedure room on the trolley. There will be a doctor, nurse and radiographer with you throughout the procedure.

What actually happens during an oesophageal stent insertion?

• You will be asked to lie on the X-ray table.
• Monitoring equipment will be attached to you so we can record your pulse and oxygen level, as well as monitor your blood pressure and heart rhythm.
• You will be given a local anaesthetic throat spray to help numb the throat.
• We will give you oxygen through a small soft tube placed into your nostrils.
• A plastic mouth guard will be placed in your mouth. This allows the endoscope (small camera) and/or a soft guidewire to pass through your mouth.
• A nurse will stand by your head and monitor you for the whole procedure.
• Once you are comfortable the endoscope and/or guidewire will be passed through your mouth, down your gullet into the stomach.
• The stent is then passed over the guidewire into the correct position across the blockage. Finally, the endoscope and/or guidewire is removed.

Will it hurt?

Some discomfort may be felt in your throat, but this should not be too sore. There will be a nurse standing next to you and looking after you. If the procedure does become painful for you, then they will be able to arrange for you to have painkillers through the cannula in your arm.

How long will it take?

Every patient’s situation is different, and it is not always easy to predict how complex or straightforward the procedure will be. It will probably be over in 45 minutes, but occasionally it may take an hour.

What happens afterwards?

You will be taken back to the day case area on a trolley. Nurses there will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no problems. You will generally stay in bed for a few hours, until you have recovered.

How soon can I eat and drink, and what happens next?

Most patients will be able to start on fluids within a few hours. It is then necessary to have a fairly liquid diet for a few days, until starting on soft solids. More solid food should be chewed properly before swallowing. Depending on how well the stent has overcome the blockage/narrowing, you may be back on a fairly normal diet within a week or so.

Things to remember:

• Do not continue to eat or drink if you feel something is stuck at the back of your throat. Contact your GP if this happens.
• If you feel your swallowing difficulty recurs, seek your GP’s advice, as there is a likelihood that the stent may be blocked and requires a further examination or treatment.

Are there any risks or complications?

Oesophageal stent insertion is a safe procedure, but there are some risks and complications that can arise, as with any medical treatment.

• It is possible that a little bleeding occurs during the procedure, but this generally stops without the need for any action.
• It is normal to experience moderate chest pain while the stent “beds in”, but this normally settles in a day or two. Some patients get heartburn afterwards and need to take medicine for this.
• Very rarely the stent may slip out of position, and it is necessary to repeat the procedure.
• Very, very rarely, putting the stent in may cause a tear in the oesophagus. This is a serious condition, and may need an operation, or insertion of another stent.

Despite these possible complications, the procedure is normally very safe.

Finally

We hope this information is helpful. If you have any questions, either before or after the procedure, the staff in the Imaging Department will be happy to answer them. The phone number for the Imaging Department can be found on your appointment letter.

Dietary advice and consideration: 

Remember to chew your food well before swallowing and have fluid available when having your meal. Supplementary high nutritious drink may be necessary to maintain your weight.

Example

Meat: Cut into small pieces, or minced.

Cheese: Grated or in sauce.

Puddings: Creamy yoghurt, custard etc

Fruit & veg: Well cooked, pureed or liquidised. Smoothies.

Cereals: Porridge, Ready Brek.

References

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT003149.