Oesophageal pouch

Also known as Pharyngeal pouch or diverticula or Zenker's Diverticulum.

In Preparation

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From the US National Institute of Health, National Library of Medicine, 2001 entry,
Pharyngeal pouch (Zenker's diverticulum), definition, occurrence, symptoms, aetiology, management etc.

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Zenker's Diverticulum, also known as pharyngoesophageal diverticulum, is a rare condition that can be associated with acid reflux, among other causes. In this chapter, we will explore Zenker's Diverticulum, its causes, symptoms, diagnosis, and available treatments.

What is Zenker's Diverticulum?

Zenker's Diverticulum is a pouch-like outpouching or herniation that occurs in the pharynx, specifically in the posterior hypopharyngeal wall. It is characterized by a sac-like protrusion that develops between the upper esophagus and the lower part of the throat, or pharynx. While it can occur for various reasons, it has been linked to acid reflux in some cases.

Causes of Zenker's Diverticulum

The exact cause of Zenker's Diverticulum is not always clear, but it has been associated with several factors, including:

1.  Swallowing Disorders: Difficulty swallowing, known as dysphagia, can lead to the development of a diverticulum as the weakened muscles in the throat and upper esophagus struggle to move food or liquid into the stomach.

2. Chronic Acid Reflux: Acid reflux or gastroesophageal reflux disease (GERD) can irritate and weaken the tissues of the upper esophagus and contribute to the development of a diverticulum over time.

3. Increased Pressure: Increased pressure in the throat due to conditions like frequent coughing, vomiting, or straining during bowel movements can also be a contributing factor.
   
   

Symptoms of Zenker's Diverticulum

The most common symptoms of Zenker's Diverticulum include:

1.  Dysphagia: Difficulty swallowing, often with a sensation of food or liquid getting stuck in the throat.

2.  Regurgitation: The regurgitation of undigested food or foul-smelling substances from the diverticulum.

3. Coughing and Choking: Due to the accumulation of food particles in the pouch.

Diagnosis of Zenker's Diverticulum

To diagnose Zenker's Diverticulum, a healthcare provider may use several methods, including:

1. Barium Swallow Test: This imaging test involves swallowing a barium solution that can highlight the diverticulum on X-rays.

2. Endoscopy: A thin, flexible tube with a camera (endoscope) is inserted through the mouth and throat to visualize the diverticulum directly.

3. Manometry: This test measures the pressure and function of the esophagus and can help identify any swallowing disorders.

Treatment Options

The management of Zenker's Diverticulum typically involves one of the following treatment options:

1. Dietary and Lifestyle Changes: Adjusting the diet and eating habits to include softer foods and avoiding foods that may aggravate the condition.

2. Endoscopic Diverticulotomy: A minimally invasive procedure to cut the septum between the diverticulum and the esophagus, allowing the pouch to drain properly.

3. Surgery: In severe cases or when other treatments are ineffective, surgical removal of the diverticulum may be necessary.

Conclusion

While Zenker's Diverticulum is a rare condition, it can be associated with acid reflux and other factors that affect the swallowing process. Early diagnosis and appropriate treatment can alleviate symptoms and improve the quality of life for those affected by this condition. If you suspect you may have Zenker's Diverticulum, it's essential to consult a healthcare professional for an accurate diagnosis and tailored treatment plan.

Page updated 23 October 2023