Patients of middle and older age are often diagnosed with such a pathology as esophageal diverticulum. In people under 40 years, this disease is much less common, and in children only in exceptional cases can the congenital form of the disease develop due to problems in the formation of the esophagus during intrauterine development. The question of what kind of disease it is and how dangerous it is can be called the most frequent. This pathology is characterized by the appearance of sack shaped or funnel-shaped protrusions( diverticula) in the region of the esophagus, into which a part of the person eaten falls. The classification of this disease is very diverse. Experts mainly use 3 criteria: by the time of origin( acquired and congenital), by type of structure and mechanism of education and by localization. If the first criterion of the esophageal diverticulum is more or less clear, then the remaining 2 should be considered in more detail. In the place of localization, the following subtypes are distinguished by specialists:
- A pharyngeal esophageal diverticulum. In turn, it is subdivided into 2 species, the Tseker and the pharyngo-esophageal ones. The most common is the Center, which is located on the back of the larynx, slightly higher than the beginning of the muscular tube that connects it to the stomach. It's called - a pharyngeal pocket. Therapeutic measures in this case mostly involve the use of medicines, antibiotics, nutrition correction and recipes of traditional medicine. Surgical operations for esophageal diverticula are necessary only when the above methods are ineffective;
- In the middle part of the esophagus, endobronchial diverticula are distinguished. Place their location in the middle of the sternum. Treatment is carried out exclusively by removal. After the patient is given a diet, antibacterial drugs are prescribed;
- Epiphrenal pathological saccate protrusion is located in the very third quarter of the esophagus. In this case, surgery is necessary with subsequent conservative therapy.
According to the type of structure and mechanism of education, diverticula are divided into pulsion, traction and mixed. The difference is that the pulsatile diverticula develops when, as a result of motor disruption in the esophagus, the pressure rises and the wall protrusions in weaker places occur. The main reasons contributing to the emergence and development of pathogenic pockets of this type include swallowing too large unrefined lumps during a hasty meal or a sharp spasm of the pharynx in nervous people.
Tractional diverticula can appear in the case when the esophagus wall fuses with surrounding organs. Usually this situation arises from the inflammatory process occurring in the lymph nodes in the roots of the lungs or the trachea. In this case, the organ to which a part of the muscular tube is "soldered" begins to pull it onto itself, which is why the stretching and formation of the protrusion of its wall occurs. The traction type corresponds only to endobronchial protrusions. All other pathological "bags" that develop on this organ are related to pulsed.
For a pathology such as esophageal diverticulum, ICD-10( international classification of diseases), gives a complete description. Thanks to ICD-10, it is possible to select the right diagnostic measures to identify the form of the disease, depending on the causes that caused it, and the selection of the most appropriate treatment. Also, it describes the possible symptomatology, which allows us to clarify the type of pathology and the location of its location by certain features. But experts categorically do not recommend patients, using the electronic version of ICD-10, to diagnose in themselves diverticula of the esophagus and to engage in self-medication.
Symptoms of diverticulum of the esophagus
Symptomatic of diverticula depends on their location. To make it easier to understand the alarming signs, you should consider it in more detail.
The zenker diverticulum, which is pulsed and formed on the back wall of the pharynx due to eating in a rush and ingesting large unprocessed pieces of food, can vary in size from cherry berries to adult fists. At first, the symptoms do not worry the patient very much. The most frequent signs noted by the patient at this time consist in infrequent violations of the swallowing function, sensation in the throat of the foreign body, dry cough, persistent sperm in the pharynx and increased salivation. Gradually, as you grow on the back wall of the upper esophagus of Zenker's diverticulum, the symptoms begin to increase, unpleasant signs appear after each sip, food can be thrown into the throat and into the respiratory tract, and vomiting often occurs. Food is not carried out naturally in the stomach, but stagnates, thus provoking not only a putrid odor from the mouth, but also the possible development of inflammation. Perforation can easily come as a result of any instrumental intervention, gastroscopy or probing. At the initial stages of the development of this pathology, it does not require specific drug therapy and antibiotic treatment or a special surgery to remove it. It is enough to correct nutrition and therapy with folk remedies.
Epiphrenic diverticulum of the esophagus takes the 2nd place in the prevalence, and by the mechanism of formation, the cause of occurrence, is mixed, i.e., traction-pulsed. Symptoms and signs in most cases do not appear at all. Only in some patients is manifested lubricated symptoms, which can be attributed to various pathologies of the gastrointestinal tract, it is food delay and dull pain localized in the xiphoid process, a feeling of "stake" behind the sternum, frequent regurgitation, etc. Epiphrenic diverticulum of the esophagus due to the absence of certain external manifestations is alwaysrandom roentgenological finding. In this regard, with its development in the patient due to prolonged stagnation of undigested food residues, inflammation often develops.
Diagnosis of esophageal diverticulum
The main research method used to detect the disease is fluoroscopy of the esophagus with contrasting barium sulfate. Also used are computed tomography and chest X-ray survey. The possible use of endoscopy is almost always excluded due to the risk of perforation of the diverticulum. But with the progression of the pathology and the increase in protrusion, endoscopy is simply necessary, since it can be used to detect not only the presence of pockets on the GI tract walls, but also to diagnose the onset of inflammation in them, the presence of a malignant tumor or polyp, ulceration of the mucosa and bleeding.
Patients are always interested in how the esophagus diverticulum is performed most correctly? After visual examination and palpation, the doctor prescribes contrast radiography. It allows you to see the location and size of the bag itself. If necessary, the doctor can prescribe an endoscopic examination, which is carried out with extreme caution, in order to prevent perforation. This method is applied mainly to the epiphrenic form of diverticula, since the Tseker's can be determined even without the aid.
Also all people who are so unhappy with the diagnosis are interested in what are the most frequent complications of esophageal diverticula. Here experts mark the following:
- Inflammation of diverticula, which always causes their suppuration and breakthrough. As a result, stenosis( constriction) of the esophagus lumen and bleeding in it form;
- The appearance of fistulas and their subsequent degeneration into malignant tumors;
- Esophageal diverticulitis often causes bronchi, pleurisy, lung abscess and aspiration pneumonia.
Treatment of diverticula of the esophagus
Small diverticula with mildly expressed symptoms are treated with conservative methods under the supervision of a specialist. Patients are strongly recommended to take antibacterial drugs against a background of sparing diet and complete correction of the diet. People's recipes are also used. The food should be selected in such a way as to prevent thermal, mechanical and chemical damage to the esophagus and not cause complications and inflammation.
In the event that pathological protrusions progress in development and are accompanied by pains, severe course, surgical treatment is necessary. All operations to remove diverticulum of the esophagus are carried out with endoscopic assisting. In favor of the endoscopic method of conducting operations, the lowest incidence of side effects is indicated.
Well proven in the treatment of diverticulum esophagus and folk remedies. To cure completely, that is, to return the body of the digestive tract to the place of the body, with the help of this method it is impossible. But in the case of Zenker's diverticula, especially in the early stages, when the operation is not recommended, folk remedies help to quickly get rid of all the negative symptoms.