What are esophageal pouches?
Esophageal pouches, also known as Zenker's diverticulum, are outpouchings of the esophageal lining that occur in the upper part of the esophagus, which is the muscular tube that carries food from the throat (pharynx) to the stomach. The presence of esophageal pouches can cause a variety of symptoms, including:- Difficulty swallowing (dysphagia)
- Regurgitation of undigested food
- Bad breath (halitosis)
- A feeling of fullness or a lump in the throat
- Coughing or wheezing
- Recurrent chest infections
- Hoarseness or changes in voice
- Weight loss
The exact cause of esophageal pouches is not fully understood, but it is thought to be related to a combination of factors, including:
- A weakness in the esophageal wall
- Increased pressure in the esophagus, such as from frequent vomiting or coughing
- Achalasia, a condition in which the muscles of the esophagus do not work properly and the food does not move down the esophagus properly
Diagnosis of esophageal pouches usually involves a combination of tests such as:
- Physical examination
- Esophagogastroduodenoscopy (EGD), a procedure in which a thin, flexible tube with a camera on the end is inserted into the esophagus to visualize any abnormalities
- Barium esophagram, an X-ray of the esophagus after drinking a barium liquid to outline the esophagus and any pouches
- Manometry, a test to measure the pressure and muscle contractions of the esophagus
Treatment options for esophageal pouches may include:
- Conservative management: This may involve dietary modifications, such as eating soft or liquid foods, avoiding certain trigger foods, and elevating the head of the bed to reduce reflux.
- Endoscopic therapy: This involves using a specialized endoscope to remove the pouch or to repair the underlying weakness in the esophageal wall.
- Surgical therapy: This is usually considered for larger or more complex pouches and involves removing the pouch and repairing the esophageal wall.
It is important to note that the approach to managing esophageal pouches may vary depending on the individual case and the specific symptoms and findings.