Esophageal dilation

For the following points: (A), prospective controlled trials; (B), observational studies; (C), expert opinion.•Dilation is indicated in patients with symptomatic esophageal strictures (B).•Fluoroscopy is recommended when using non-wire-guided dilators during dilation of complex esophageal strictures or in patients with a tortuous esophagus (B).•Bougie and balloon dilators are equally effective in relief of dysphagia in patients with esophageal strictures (A).•The rule of 3 should be followed when dilation of esophageal strictures is performed with bougie dilators (B).•Injection of corticosteroids into recurrent or refractory benign esophageal strictures may improve the outcome after esophageal dilation (B).•Pneumatic dilation with large-diameter balloons is effective for the treatment of achalasia (A).•Botulinum toxin therapy is the preferred endoscopic treatment for achalasia in poor operative and nonoperative patients (B).•Administration of PPIs is effective in preventing recurrence of esophageal strictures and the need for repeat esophageal dilation (A). © 2006 American Society for Gastrointestinal Endoscopy.