Having
an Oesophageal Stent - A guide for patients
Having an Oesophageal Stent - A guide for patients- booklet coverYou may be having problems with swallowing. Your doctor has
suggested that a stent will help to improve these difficulties.
Contents
What
is a stent
A stent is a tube made of a flexible metal mesh. It is passed
by mouth into the oesophagus (gullet) and positioned across the area
that has narrowed. It gently expands to allow fluid and foods to pass
through to the stomach more easily.
What
does a stent look like?
How
do I prepare for my stent insertion?
If you are not already an in-patient you will be admitted
to hospital on the morning of the procedure. Your stomach needs to
be empty, so don't have anything to eat or drink for at least
six hours before the stent insertion. The staff will take you to the
Endoscopy Unit and a small needle (cannula) will be placed in a vein
in the back of your hand so we can give you a drug to relax you (sedation).
You will not be asleep. We will attach a probe to one of your fingers
to allow us to measure the amount of oxygen in your bloodstream. You
may also have some extra oxygen through small tubes placed under your
nose.
How
long will it take?
The procedure will probably take about 20 minutes but occasionally
can be longer. After you have recovered from the sedation, you will
be taken back to the ward where the staff will look after you.
How
is the stent inserted?
The surgeon sprays the back of your mouth with a local anaesthetic
to numb your throat. You will be given sedation and a flexible tube
(endoscope) with the stent attached is then passed down your throat,
into your oesophagus and past the narrowed area. Once the surgeon is
happy with the position of the stent, it is released and will begin
to gently expand. The endoscope is then removed from your oesophagus
leaving the stent in place.
Will
it hurt?
There can be chest or back pain or discomfort afterwards as the stent
beds in, but this usually settles after a day or two. There are several
ways of treating this and your surgeon will discuss this with you before
the procedure. It is important that you let your nurse or doctor know
if you are uncomfortable so that you can be offered appropriate medication.
What
are the risks and benefits?
Stent insertion is generally a safe procedure, but as with
all medical treatments there are some risks:
- Minor bleeding can occur during the procedure. This generally
stops without further treatment.
- Some people get heartburn and acid reflux afterwards. This can
be controlled with simple measures or medicine if necessary.
- Rarely, the stent may slip out of position and the procedure may
need repeating.
- Occasionally it may not be possible to fit or place a stent for
technical reasons. If this is the case, your consultant will discuss
this with you.
- Very rarely, inserting the stent may cause a tear in the oesophagus.
This is a serious complication and may require an operation or another
stent inserting.
Despite these possible complications, the procedure is generally very
safe and will result in an improvement in your symptoms. After a few
days you should not be aware of the stent being in place.
When
will I be able to eat and drink?
After about one hour the numb feeling in your throat wears off and
you can have a drink followed, a couple of hours later, by soft food.
You can then gradually begin to eat more.
When
will I be able to go home?
You will stay in hospital overnight or until we are happy that you
are fully recovered and you are able to eat and drink comfortably.
What
kind of food can I eat?
It is advisable to begin by eating liquidised meals and progress to
soft, moist foods if you feel comfortable. There are some foods that
may be difficult for you to swallow, and you should avoid them as they
can block your stent: -
Foods to AVOID
- Fish
- Tough fibrous meats
- Fresh/doughy crispy bread
- Hard foods such as nuts, crisps, crackers, hard chips
- Hard boiled eggs
- Fruit with pith, pips and stringy texture e.g rhubarb, strawberries,
raspberries, kiwis
- Vegetables with pips and stringy textures eg celery, green beans,
sweetcorn, peas,Broccoli and cauliflower
stalks
Suitable alternatives
- Tender meat/poultry
- Old bread
- Scrambled, poached, omelette, egg mayonnaise
- Bananas, melon (remove pips)Skinless grapefruit/orange segmentsStewed
apple (no skins/pips)Seedless and skinless grapesPeaches and nectarines
(no skin/pips)
- Vegetables without pips and stringy textures eg carrot, parsnip,
broccoli, cauliflower tips, courgette.Mushy peas
Looking
after your stent
- Sit upright when you eat and try to relax.
- Take small mouthfuls of food.
- Eat slowly and chew your food well.
- Use plenty of sauces, gravy and butter to moisten food.
- If your appetite is poor, try to have small and frequent nourishing
meals.
- Try to have warm drinks whilst eating to prevent the tube from
blocking.
Have nourishing drinks between meals. There is useful advice in the
Christie booklets: - Using nutritional drinks and Advice About
Soft and Liquidised Food. (For copies: ask the ward staff, visit the
Cancer Information Centre or look on the website)
What
if the stent becomes blocked?
tent blockage usually causes pain or difficulty on swallowing or regurgitation
of food. Try not to panic if you feel that your stent is blocked. The
following actions may help: -
- Stop eating.
- Try standing up and walking around the room.
- Take small sips of a fizzy drink.
- If the blockage persists contact your doctor or local hospital.
Can
the stent come out?
nce the stent is in place it will usually be permanent. In unusual
circumstances the stent may slip out of position, but it is unlikely
that we would attempt to remove the stent unless absolutely necessary.
If
you have any further questions please contact
- Mr. I. Welch, Consultant Oesophagogastric Surgeon 0161 446 3364
- Mrs. A. Burgess, Upper GI Nurse Clinician 0161 446 8099
- Ms. J. England, Acute Pain Specialist Nurse 0161 446 8050
For advice between 5.00pm and 8.00am and weekends
- Night Nurse Practitioners 0161 446 3868
- or ring 0161 446 3000
and ask for Nurse to be bleeped
Useful
national groups
Oesophageal Patients' Association
16 Whitefields Crescent
Solihull,
West Midlands B91 3NU
Cancerbackup
Information available from the leaflet racks on the wards and in Outpatients
Department and the Cancer Information Centre:
The Cancer Information
Centre on the glass link corridor at the Christie keeps a wide
range of Christie and other booklets.
The Christie Patient Information Service May 2003
CHR/SUR/106/19.05.03