Zenker’s Diverticulum

What Is Zenker’s Diverticulum?

The Zenker’s diverticulum is also known as pharyngoesophageal diverticulum. Diverticulum is an out pouching of a part of a body. This out pouching can be fluid-filled in characteristic. The condition is not to be taken lightly as this present severe complication. It has been reported that this condition was described thoroughly by Dr. Friedrich Zenker in 1877 and was sought to be acceptable rather than the previous descriptions of the disease. Ever since, his name was coined with the disease condition.

This condition is said to be common or quite a number were noted in the northern Europe. This is a rare condition in Asian heritages. The prevalence rate is said to be in the case-population ratio 2:100,000 people. It is also reported that men are more affected than women and that the elders are also much affected than the young ones.

Zenker’s Diverticulum Location

Zenker’s diverticulum is said to be located at the pharyngeal mucosa or simply in our pharynx but specifically above the cricopharyngeal muscle. To be more exact and clear, it is above the sphincter of our esophagus. There are reports that the muscle may have some spasm problems in order for it to develop to such.

Picture 1 : A. Zenker’s Diverticulum Location; B: Barium X-Ray of Zenker’s Diverticulum

Image source : drugster.info

Picture 2 : Zenker’s Diverticulum (pharyngoesophageal diverticulum)

Image source : nature.com

Symptoms

The Zenker’s Diverticulum has a number of symptoms and it is nearly disabling to the affected. It has been noted that the sufferers are to experience such symptoms for months and even years. The following are the said manifestations of this condition:

1. Food usually comes back up from to the mouth after hours of eating.
2. Difficulty of swallowing the food is a common manifestation. This is medically termed as dysphagia.
3. There is a sensation that food is seemed to be stuck in the throat. There is a choking feeling.
4. Tendency of the client is coughing up after eating.
5. He client may suffer from weight loss.
6. Bad breath or halitosis is noted.
7. Some note distinct noises in the neck.

Zenker’s Diverticulum Causes

The cause of Zenker’s diverticulum is said idiopathic or from an unknown cause. The out pouching of the affected area is not believed to be non-hereditary. There are some pointers that the condition has started from an underlying esophageal problem. There have been uncertain beliefs from the root cause of Zenker’s diverticulum. Nothing has been helpful in supporting such diagnosis. But others noted that factors such as these influence the development of Zenker’s diverticulum:

1. Abnormality of the cricopharyngeal muscle and upper esophageal sphincter.
2. The elastic capability of the cricopharyngeal muscle has been altered or lost.
3. There has been an injury rendered at the central nervous system.

Radiology

The condition is said to be diagnosed through this confirmatory test, such as barium swallow with the procedure videofluoroscopy. This test shall involve viewing of the throat area with the use of this contrast medium, x-ray films are to be obtained in order to see any out pouching of the affected area. This could also be done with the use of videofluoroscopy which shall record or a form of motion x-ray to capture images of the affected area.

Zenker’s Diverticulum Treatment

Treatment for Zenker’s Diverticulum is aimed in alleviating the presenting symptoms of the client. It has been known that the best option for this condition is to do nothing. This shall only warrant for an intervention when it has come to a point of disability to the client. Alternative treatments are provided such as managing the manifestations:

1. Take or eat foods that are easy to swallow. Soft foods are recommended so that it shall not be blocked in the throat. Maintain a rich diet so to avoid weight loss.
2. Follow strict oral hygiene.

Diet for Zenker’s Diverticulum

Diet for Zenker’s diverticulum is important as this is usually altered when one is suffering from such condition. As the person has difficulty swallowing food and even has a tendency to choke, the following are recommended for them after a surgical procedure:

1. Intake of soft foods.
2. It is recommended that the person shall eat or chew ice chips in order to relieve swelling and avoid the bleeding tendency of the patient.
3. Provide high protein foods such as fish, meat and chicken.
4. One should avoid high carbonated drinks or any form of drink that can damage the incision on the surgical intervention. Thick liquids are example of such. Chewing of gums is also prohibited.
5. Remember that introduction of food to client post surgery should be gradual.

Zenker’s Diverticulum Surgery

There are a number of surgical interventions for Zenker’s diverticulum. The following are the presented options for the medical condition:

1. Cricopharyngeal myotomy. This is known in the 70s as the first surgical intervention for Zenker’s diverticulum.
2. Transcervical surgery. There shall be resection of the diverticulum. This is said to prevent the recurrence of the condition. A general anesthesia is required from this procedure.
3. Dohlman procedure. This is aimed to correct the diverticulum. The pouch is to be removed.
4. Endoscopic staple diverticulotomy. This is believed as the procedure of choice for Zenker’s diverticulum. There is a use of an endoscope which shall aid in placing a blade on the affected area. A stapler is then used to cut the pouch from the esophagus.
5. Surgery Complications
6. Complications are somehow cannot be avoided. The following are the proposed complications of Zenker’s diverticulum:
7. Hematoma. Also known as blood clot formation.
8. Esophageal perforation. Injury is prompted during an operative procedure. There is said to be formation of a hole from where to food passes.
9. Esophageal stenosis. There is narrowing of the esophagus. This shall tend to be a more problem to the affected for it can result to swallowing difficulties.