In some patients, especially the elderly, a condition can occur in the upper esophagus where a pouch develops that can cause difficulty with swallowing and bad breath due to food captured within. This condition is known as Zenker’s Diverticulum and can involve a relatively small pouch or one of significant size. The size of this pouch determines whether the condition is classified as intermediate, small, or large ZD.
What Causes Zenker’s Diverticulum?
Within the structure of the neck is a muscle known as the cricopharyngeus muscle that is the upper esophageal sphincter. This sphincter is located just below the voice box, and under normal circumstances will relax to permit food to pass through. In cases where this doesn’t occur the food has to push past the sphincter, putting pressure on the hypopharynx and creating a slight bulge. Like material that has been stretched once too often the hypopharynx can, over time, form Zenker’s Diverticulum, permanent bulge or pouch that continues to grow as this process continues. Those who are elderly or have suffered from neurological diseases, including stroke, are more likely to develop ZD.
What Are The Symptoms of Zenker’s Diverticulum And How Is It Diagnosed?
Symptoms that can point to this condition include:
- Discomfort With Swallowing
- Undigested Food Being Regurgitated Hours After Eating
- Sensation Of Food Being Stuck In The Throat
- Choking or bleeding caused by food or liquid being aspirated
- Halitosis (Bad Breath)
- Weight Loss Not Otherwise Explained
Diagnosis of this condition typically begins with a diagnostic treatment known as a barium swallow. During this study a liquid that is opaque to imaging equipment is swallowed, allowing the radiologist to study the shape of your esophagus and hypopharynx. The ZD will be made clearly visible, and often the indentation caused by a tight cricopharyngeus muscle will also be revealed.
What Treatment Options Exist For Zenker’s Diverticulum?
In cases where Zenker’s Diverticulum is symptomatic it is possible that your doctor may recommend surgery. This procedure will sever the cricopharyngeus muscle and thereby remove the pouch in most cases. However, in the event that a particularly large diverticulum is present additional surgery may be necessary to remove the pouch itself. This procedure can be performed in one of two ways:
External: This surgery is performed through an incision in the neck, allowing the surgeon to locate and sever the muscle.
Endoscopic: Less invasive than the external procedure a diverticuloscope is inserted in the mouth which, along with an endoscopic stapler, is used to sever the muscle and opens the ZD to the esophagus.
Recovery from the endoscopic procedure is much easier, typically allowing the patient to return home after the procedure. In some cases, an overnight stay in the hospital will be necessary.
If you believe you may have Zenker’s Diverticulum or have questions about the condition and associated procedures, contact your pain management doctor in Las Vegas, NV for a consultation and exam. If Dr. Yevgeniy Khakin believes that this condition may be present diagnostic procedures will be scheduled at Khavkin Clinic.