Oesophageal diverticula

Overview

An oesophageal diverticulum (plural: diverticula) is a protruding pouch in the lining of the oesophagus. This pocket-like structure is caused by internal pressure from a swallowing disorder or by external pressure, e.g. due to scarring. Diverticula typically form in weak spots in the oesophagus. Symptoms include swallowing difficulties, a tickle in the throat and bad breath. Undigested food is regurgitated.

Symptoms

• Swallowing difficulties
• Foreign body sensation in throat
• Tickle in throat
• Bad breath
• Regurgitation of undigested food
• Pain in upper abdomen
• Pressure and pain behind the sternum
• Sometimes, coughing up of food residues at night (see pillow)

Complications

• Food residues get sucked into the airways (aspiration)
  • Coughing, shortness of breath
  • Pneumonia
• Perforation, formation of fistula (passages)
• Bleeding of diverticula (seldom)

Causes and treatment

Causes

True diverticula

• Inflammation and scarring of lymph nodes
• Consequence
  • Oesophagus is stretched through external pressure
  • Entire wall bulges outwards

False diverticula

• Impaired relaxation of upper or lower oesophageal sphincter muscles
• Consequence
  • Impaired swallowing
  • Feeling that food is caught in the throat
  • Increased pressure in oesophagus
  • Bulging of mucous membrane

Further treatment by your doctor / in hospital

Possible tests

• X-ray (swallow test with contrasting agent)
• Oesophagoscopy
• Measurement of oesophageal pressure

Possible therapies

• When in discomfort: surgical removal of diverticulum

What can I do myself?

• Active prevention isn’t possible
• Balanced diet
  • Low in fat
  • Rich in fibre
  • Lots of fruit and vegetables
• Small portions (to protect digestive tract)
• Avoid acidic and carbonated food and beverages
• No alcohol
• Don’t go to bed on a full stomach

When to see a doctor?

• Swallowing problems for several weeks
• Regurgitation of undigested food residues
• Foreign body sensation in throat
• Pain
  • When swallowing
  • At night
  • Behind the sternum

Synonyms

oesophageal diverticula, oesophageal diverticuli, Zenker's diverticulum, diverticula of the oesophagus, oesophageal pouches, Zenker's diverticula, traction diverticula, pulsion diverticula, esophageal diverticula