About Esophageal Diverticulum

Overview
An esophageal diverticulum is a protruding pouch that forms in a weak area of the lining of the esophagus. It can occur in different parts of the esophagus, including near the top, middle, or lower part. This condition is relatively rare and tends to affect older adults. While some people may not experience any symptoms, others may have difficulty swallowing. Treatment options for esophageal diverticula include lifestyle changes, surgery, or a combination of both. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment recommendations.
Causes and Risk Factors

The causes of esophageal diverticulum are still not fully understood. However, experts believe that increased pressure within the esophagus plays a role in its development. This increased pressure can be caused by various factors such as:

  • Malfunction of the sphincters (ring-shaped muscle that can tighten or relax) on either end of the esophagus
  • Inflammation from outside the esophagus
  • Food not moving properly through the esophagus
  • Malfunctioning of the swallowing mechanis
  • Complications from surgical procedures near the neck
  • Conditions that affect collagen, such as Ehler-Danlos syndrome

Risk factors for esophageal diverticulum include:

  • Older age (greater than 50 years old, especially greater than 70 years old)
  • Genetic syndromes
  • Diseases that affect swallowing (achalasia, esophageal spasms, and esophageal strictures)
  • Infections (tuberculosis and fungus infections)

It's important to note that these risk factors may increase the likelihood of developing esophageal diverticulum but do not always cause esophageal diverticulum. Some people develop esophageal diverticulum without having known risk factors.

Symptoms

Common early symptoms of esophageal diverticulum include:

  • Difficulty swallowing
  • Feeling like food is caught in the throat
  • Regurgitating food when bending over, lying down, or standing up
  • Pain when swallowing
  • Chronic cough
  • Bad breath

As esophageal diverticulum progresses or reaches a higher severity, additional symptoms may occur, such as:

  • Chest pain
  • Neck pain
  • Weight loss
  • Vocal changes
  • Gurgling sound when air passes through the diverticulum

It's important to note that esophageal diverticulum doesn't always cause problems, and symptoms tend to come on slowly as the pouch grows. If you experience any of these symptoms, it's best to consult with your healthcare professional for an accurate diagnosis and appropriate management.

Diagnosis

To diagnose esophageal diverticulum, doctors may perform the following examinations, tests, and procedures:

  • Barium swallow: You will be asked to swallow a solution containing barium, which shows up on an X-ray or computed tomography (CT) scan. This allows your doctor to track the movement of fluid through your esophagus.
  • Upper gastrointestinal endoscopy: A thin, flexible tube with a camera at the end is inserted through your mouth and down your throat to view your esophagus.
  • Esophageal manometry: This technique measures the timing and strength of the contractions of your esophagus.
  • 24-hour pH test: This test measures the pH in your esophagus over a 24-hour period to check for signs of stomach acid or bile in your esophagus.

To determine the stage or severity of esophageal diverticulum, additional examinations, tests, and procedures may be performed:

  • Computed tomography (CT) scan: This imaging test provides detailed images of your esophagus and surrounding structures.
  • Magnetic resonance imaging (MRI) scan: This imaging test uses powerful magnets and radio waves to create detailed images of the esophagus and surrounding tissues.
  • Laparoscopy or thoracoscopy: These minimally invasive procedures involve inserting a camera into the chest or abdomen to assess the extent of diverticulum.

Remember, these are general descriptions, and specific examinations/tests may vary depending on individual circumstances. Consult with your healthcare professional for personalized advice.

Treatment Options

In cases where esophageal diverticula is not causing symptoms, treatment may not be necessary. When treatment is recommended, treatment for esophageal diverticulum may include:

  • Medications:
    • Over-the-counter antacids: These can help with mild symptoms by reducing acid in the stomach.
  • Lifestyle changes:
    • Thoroughly chewing food
    • Eating a bland diet
    • Drinking plenty of water after meals
  • Surgical procedures: In more severe cases, surgery may be necessary to remove the diverticulum and repair weakened tissue in the esophagus. These procedures aim to widen the upper sphincter of the esophagus, remove the diverticulum, and allow food to drain properly.

Talk with a healthcare professional for personalized advice and treatment options for esophageal diverticulum. Medication dosing may be affected by many factors and side effects may occur with medication. Check with your health care professional about dosing for your individual situation. Read the information provided with your medication for additional sides effect information.