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Esophageal Diverticulum

An esophageal diverticulum is a protruding pouch or pocket-like structure that occurs in a weak portion of the esophageal lining. Diverticula can appear anywhere in the esophageal lining between the throat and stomach and are classified by their location, with Zenker’s diverticula (located in the back of the throat) being the most common. Other forms of esophageal diverticula include midthoracic, which appears in the mid-chest region, and epiphrenic, which exists above the diaphragm.

What Can Cause an Esophageal Diverticulum?

The exact causes of esophageal diverticula are still unknown, but it is a condition that can either exist at birth or develop later in life. In adults who develop esophageal diverticula, the condition is often linked to increased pressure within the esophagus which then causes the lining to protrude in a weakened area.

Signs & Symptoms of Esophageal Diverticula

Symptoms of esophageal diverticula center on the esophagus and problems with swallowing.

Specific signs include:

  • Difficulty swallowing (dysphagia) or feeling like food is caught in the throat
  • Pain when swallowing
  • Regurgitation of swallowed food and saliva
  • Chronic cough
  • Bad breath (halitosis)
  • Chest or neck pain
  • Unexplained weight loss
  • Gurgling sound as air passes the diverticulum (Boyce’s sign)

Diagnosing Esophageal Diverticula

A medical professional can diagnose an esophageal diverticulum through the use of one or more tests:

  • Barium swallow – A patient swallows a barium solution that will show up on an X-ray or CT scan as it moves through the esophagus.
  • Gastrointestinal endoscopy – An endoscope (narrow, flexible tube with a camera) is inserted through the mouth and down the throat to provide a view of the esophagus.
  • Esophageal manometry – This test is used to measure the timing and strength of esophagus contractions and muscular valve relaxations.
  • 24-hour pH test – The pH of the esophagus is measured over a 24-hour period to check for signs of stomach acid or bile.

What Are the Treatments for Esophageal Diverticula?

In mild cases, an esophageal diverticulum can be treated through lifestyle changes such as eating a bland diet, thoroughly chewing food and drinking plenty of water after eating. If symptoms are severe, however, surgical treatment is available.

Possible surgeries for esophageal diverticula include:

  • Cricopharyngeal myotomy for small diverticula
  • Diverticulopexy with cricopharyngeal myotomy for larger diverticula
  • Diverticulectomy and cricopharyngeal myotomy to remove the diverticulum
  • Endoscopic diverticulectomy that divides the tissue between the esophagus and diverticulum

The healthcare professionals at Tampa General Hospital are specialized in recognizing and treating esophageal diverticula and can create a personalized plan for treatment.