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Esophageal Pouches (Diverticula)

(Esophageal Diverticula)

By

Kristle Lee Lynch

, MD, Perelman School of Medicine at The University of Pennsylvania

Last full review/revision Oct 2020| Content last modified Oct 2020
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Topic Resources

Esophageal diverticula are abnormal pouches or pockets in the esophagus. Rarely, they cause swallowing difficulties and regurgitation Regurgitation and Rumination Regurgitation is the spitting up of food from the esophagus or stomach without nausea or forceful contractions of the abdominal muscles. Rumination is regurgitation with no apparent physical... read more (the spitting up of food without nausea or forceful contractions of abdominal muscles).

  • The cause depends on the type of diverticula.

  • Symptoms include spitting up of food and difficulty swallowing.

  • The diagnosis is based on the results of barium swallow x-rays and often upper endoscopy.

  • When needed, treatment includes surgery.

Zenker diverticula (pharyngeal diverticula)

Midesophageal diverticula (traction diverticula)

A midesophageal diverticulum is caused by inflammation located in the chest cavity outside the esophagus that pulls on the esophagus or is caused by esophageal motility disorders. A midesophageal diverticulum rarely causes symptoms, but the underlying motility disorder may.

Epiphrenic diverticula

An epiphrenic diverticulum occurs just above the diaphragm (the muscle that separates the chest from the abdomen) and usually occurs along with a motility disorder (such as achalasia or esophageal spasm). An epiphrenic diverticulum rarely causes symptoms, but the underlying motility disorder may.

Diagnosis of Esophageal Pouches

  • Barium swallow x-rays

  • Often upper endoscopy

Doctors diagnose all types of esophageal diverticula by doing a barium swallow (esophagram). In this test, people are given barium in a liquid before x-rays are taken. The barium outlines the esophagus, making abnormalities easier to see. Sometimes the barium swallow is videotaped so doctors have a recording of it.

Doctors often do an upper endoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). Endoscopy can also be used to treat many disorders because doctors are able to pass instruments... read more to confirm the diagnosis. During upper endoscopy, doctors examine the esophagus by using a flexible tube called an endoscope.

Treatment of Esophageal Pouches

  • Usually no treatment

  • Sometimes surgery

Treatment of diverticula is not usually needed.

If symptoms are severe or the pouch is large, however, the pouch can be removed surgically or corrected endoscopically.

Diverticula associated with motility disorders require treatment of the underlying disorder. For example, if a Zenker diverticulum is caused by an abnormally functioning cricopharyngeal muscle, a doctor can cut the muscle (a procedure called myotomy) when removing the Zenker diverticulum.

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Indigestion (Dyspepsia)
Indigestion (dyspepsia) is a feeling of pain or discomfort in the upper abdomen. Symptoms are usually vague and mild. Many people experience occasional dyspepsia that does not usually require medical attention. Sometimes, however, a single, sudden episode of dyspepsia may be a sign of a serious medical condition. Which of the following may cause symptoms of dyspepsia but is a true medical emergency?
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