A diverticulum, which can appear in various places in the body, is an abnormal sac or pouch that protrudes from a weak portion of the inner wall of a body part. In this case, the pouch protrudes from a weak section of the lining of the esophagus—the food tube between your throat and stomach. Usually the pouch slowly grows larger over many years, gradually producing increasing symptoms such as swallowing problems (it blocks normal passage of food and liquids), regurgitation of food, and aspiration pneumonia, which is caused by breathing in regurgitated contents of the pouch. In rare cases esophageal diverticulum can lead to cancer.What are the symptoms of esophageal diverticulum?
- Difficulty swallowing, with a feeling that food is caught in the throat
- Pulmonary aspiration, which involves secretions or foreign matter getting into the trachea (windpipe) or lungs
- Regurgitation of swallowed food and saliva
- Pain when swallowing, cough, neck pain, weight loss and bad breath
The condition mostly affects middle-aged and elderly people. Little is known about other risk factors.What tests can I expect?
Your doctor might recommend:
- Barium swallow: After you swallow a chalky liquid, doctors use X-rays to examine the liquid’s movement through your esophagus, looking for any blockage.
- Gastrointestinal endoscopy: A flexible, narrow tube with a tiny TV camera is passed down your throat and into the esophagus, projecting images of the inside of the esophagus on a screen.
- Esophageal manometry: This test measures the timing and strength of the contractions of your esophagus (peristalsis) as it pushes food downward to the stomach.
- 24-h pHmetry: This test checks for the presence of gastroesophageal reflux disease (GERD), which involves the backflow of irritating stomach acid into the lower portion of the esophagus. Over time, GERD can produce weakness in the esophagus lining, which sets the stage for the development of a diverticulum (pouch).
For patients with minor symptoms, the doctor may recommend lifestyle changes, such as eating a non-spicy diet, chewing food thoroughly, and drinking lots of water after meals.
MINIMALLY INVASIVE OR OPEN SURGERY
If symptoms grow severe, a surgical approach may be needed for relieving symptoms including a Cricopharyngeal myotomy which involves making a cut in the upper esophageal sphincter muscle (UES) at the base of the esophagus, which opens and closes to permit food and drink to pass through to your stomach. Once cut, the muscle relaxes and allows the free passage of food and liquids. This surgery can be open or minimally invasive.
If necessary, the diverticula itself can be removed.