General Surgery. Oesophageal Stent. patientinformation. Rotherham Hospital Your health, your choice, our passion

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1 General Surgery Oesophageal Stent patientinformation Rotherham Hospital Your health, your choice, our passion

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3 What is an Oesophageal Stent? This is a flexible metal tube, knitted from a special type of metal thread that enables it to be placed into your oesophagus (food pipe) where it will gently expand to hold the narrowing in your oesophagus open. How will it help me? The narrowing in your oesophagus is making it difficult for you to swallow. The stent will slowly expand opening the narrowing and making it easier for you to swallow. Who will place my stent? An experienced Endoscopist will insert the stent. How is the Oesophageal Stent Inserted? To place the stent in your oesophagus, a gastroscopy (OGD) is performed. This allows the doctor to look directly inside you with a small flexible camera called a gastroscope. Before the stent is put in position it may be necessary to stretch the narrowing by passing either a special balloon or a small stretching tube to the narrowed area. After this is done, the stent is placed across the area and will gently expand outwards and hold itself in position. 3

4 The Gastroscopy? The gastroscopy will take place in the endoscopy unit. Before the endoscopist starts the procedure, you will be given sedation. This is not an anaesthetic, but will make you feel relaxed and sleepy. Throughout the procedure oxygen will be administered through a small sponge inserted in your nostril. This is because you have had sedation and your oxygen levels may drop when you are relaxed. Recordings of your pulse and oxygen levels will be monitored. An experienced nurse will be with you throughout the procedure which will take approximately 20 to 30 minutes. Radiography (x-ray) may be used to see where the narrowing is in the oesophagus and also check the stent is in the correct position before it is placed. Are there any risks/complications? With the placement of your stent, there is a small risk of a tear occurring in your oesophagus, approximately 1 in a 100, and also a risk of bleeding. If this does happen to you, you may have to stay in hospital to receive the correct treatment, which could mean an operation. 4

5 What are the intended benefits of having an oesophageal stent inserted? The main benefit is to improve your swallowing and increase the range of foods you can eat. However, it will not restore your swallowing completely to normal and you will need to be careful about what you eat. This can be discussed with the dietitian who will be able to advise you on your diet following stent placement. Are there any alternatives available? Your doctor usually recommends an oesophageal stent when he considers it the best option for you. The alternatives are major surgery or radiotherapy. Your Doctor will discuss the options with you. After the stent has been placed After the procedure it may be necessary for you to stay in hospital overnight for observation. You will be seen by the doctor, Specialist Nurse and dietitian before you are discharged home. If you are an in-patient you will return to the ward. You may feel some discomfort/pain caused by the stretching of the oesophagus. Painkillers can be given to relieve this. Please inform the nurse of any pain or discomfort. 5

6 When you go home A responsible adult must collect and stay with you, as you will be drowsy from the medication you have been given. You must not drive a vehicle, drink alcohol or make any important decisions until the day following your discharge. This is because it takes some time for the medication to leave your system. You may resume your normal daily activities tomorrow. Remember: The effects from sedation can last up to 24 hours. You will receive a follow-up appointment in the Out-Patient Department. The Specialist Nurse will contact you following your stent procedure. You will also receive a follow-up telephone call the following morning from the endoscopy unit to make sure you are alright. Special Points to Remember l Chew well and eat slowly. Do not rush your eating. l If you have any problems, continue with the soft diet until you feel able to slowly introduce more solid foods. l Do not try and eat large lumps of food, cut them into small pieces and chew well. l Take frequent sips of fluid throughout your meal. l Sit upright when eating. l Always have a fizzy drink after eating. This will help to keep your stent free from food debris. 6

7 l Keep your teeth/dentures in good order so that chewing is effective. l If you need to take anything for pain use a dissolvable tablet or capsule such as Soluble Paracetamol. This can be bought from a chemist. l Eat a wide variety of foods to ensure you have a healthy diet. l If you feel the stent has blocked stop eating, drink a little fluid and walk around. l If you are unable to swallow for more than 3 hours, and you feel that your stent is blocked with food, try not to panic. Contact the Upper GI Specialist Nurse on Monday to Friday 8.00am to 4.00pm or the Endoscopy Unit on Monday to Friday 8.30am to 6.00pm. If your stent blocks out of hours go straight to the Accident & Emergency Department. l If at any time after you return home you have any queries or concerns, please contact the Upper GI Specialist Nurse or the Endoscopy Unit on the numbers above at the stated times. 7

8 How to look after your stent When you eat and drink always follow these guidelines: Day 1 After your procedure the doctor will recommend that you take fluids only, with no solids. Day 2 If you are able to drink and swallow well, you may start taking a soft diet. Start with small amounts, chew it well and eat slowly. Remember to take sips of fluid between mouthfuls. These foods could include soup, scrambled eggs, steamed or baked fish, yoghurts, mashed banana, well mashed potato, pate, shepherds pie, custard and ice cream. Day 3 If you have been able to swallow, you can start to try more solid food. These foods could include soft vegetables, baked beans, pasta, rice pudding and omelettes. 8

9 What you can eat Meat and Fish These foods will be easier to swallow if small amounts are added to a sauce or gravy. Please check that there are no bones in the fish. Meat should be minced not pureed. Gristle should be avoided. Ensure meat is cut into small pieces. Fruit and Vegetables These are a good source of vitamins and are important to keep you healthy. Include fruit juice or a vitamin C drink daily. Tinned fruit and soft fresh fruits are easily tolerated. Fruits can be eaten mashed or blended. Always peel fruit and tomatoes. Mashed potato can be eaten but avoid crispy chips and roast potatoes. Food supplements These can be helpful if you need extra nourishment or build up. Various flavours are available through your dietitian. Rice & Pasta To remove excess starch wash cooked rice and pasta with boiling water thoroughly before serving. Dairy Products Milk, cheese and cream are very nutritious and should be included in your diet on a regular basis. Cream cheese should be avoided. 9

10 Foods to avoid: l Cream Cheese l Fish with bones l Fried egg white and boiled eggs l Fruit skins and pith of orange or grapefruit l Green salads and raw vegetables l Hard chips and crisps l Nuts and dried fruit l Shredded and puffed wheat l Tough meat and gristle that is not minced l White bread crusty and toasted Useful contact numbers NHS Direct Telephone Patient Services Telephone Health Info Telephone Stop Smoking Service Telephone For GP out of hours, contact your surgery Useful websites If you require this document in another language, large print, braille or audio version, please contact Patient Information on or patientinformation@rothgen.nhs.uk 10 Produced by J.D Silva & M Lambertz, March Revised April Revision due April Version:1.0 The Rotherham NHS Foundation Trust All rights reserved.

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12 LS /12 V2 WFO How to contact us Upper GI Specialist Nurse Telephone Monday to Friday 8.00am to 4.00pm Endoscopy Unit Telephone Monday to Friday 8.30am to 6.00pm. If your stent blocks out of hours go straight to the Accident & Emergency Department Additional Information can be found by logging onto the following Website Oesophageal Patients Association Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone Sustainable Forests / Low chlorine