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Esophageal Diverticulum

Overview

An esophageal diverticulum is a pouch of stretched weakened tissue that develops in the esophagus, pushing outward through its muscular wall. This pocket-like structure can appear anywhere in the esophageal lining between the throat and stomach.

Esophageal diverticula are classified by their location within the esophagus:

  • Zenker’s diverticula is the most common type of diverticula of the esophagus. These are usually located in the back of the throat, just above the esophagus
  • Midthoracic diverticula occur in the middle of the esophagus
  • Epiphrenic diverticula occur at the bottom of the esophagus, just above the diaphragm

Risk Factors for Esophageal Diverticula

Esophageal diverticula are rare and can be congenital or acquired. They most often occur in adults over 50, especially those aged 70 and older.

Individuals who have a swallowing or esophageal-motility disorder, such as achalasia, related to malfunctioning sphincter muscles at the upper (Zenker’s) or lower (epiphrenic) end of the esophagus, and/or along its length (pulsion diverticula) are more prone to developing an esophageal diverticulum.

In addition, individuals with esophagitis (inflammation of the esophagus) are also at increased risk for esophageal diverticula.

Symptoms of Esophageal Diverticula

Typically, an esophageal diverticulum grows slowly over a period of years, gradually producing increasing symptoms such as:

  1. Dysphagia (difficulty swallowing)
  2. Regurgitation of indigested food (often occurs at night when lying down)
  3. Choking and coughing, especially when lying down
  4. Aspiration of diverticulum contents, which can lead to pneumonia and other respiratory infections.

Because esophageal diverticula symptoms are similar to many other conditions that cause symptoms of dysphagia, accurate evaluation is critical to ensure proper treatment. That’s why it’s important to seek care from a healthcare expert experienced in the complex diagnosis and treatment of swallowing disorders and other gastroesophageal conditions.

 

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Upper G.I. and General Surgery

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