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 Diverticula
An esophageal diverticulum is a protruding pouch in the
lining of the esophagus. It forms in a weak area of the
esophagus. o rm
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• Zenker’s diverticulum. This type develops a lP near the
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top of the esophagus. a tio
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• Midthoracic diverticulum. This , Ed type occurs in the
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middle part of the esophagus. an
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• Epiphrenic diverticulum. This type is located in the
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lower part of the esophagus.
 What are the symptoms?
Common symptoms of an esophageal diverticulum include:
• difficulty swallowing
• feeling like food is caught in the throattform
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• regurgitating food when bending over, nal lying down, or
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• pain when swallowing i sh
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• chronic cough h D
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 Cont.…
• chest pain
• neck pain o rm
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• weight loss na lP
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• vocal changes , Edu
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• Boyce’s sign, whichah Dis a gurgling sound
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when air passesAbthrough
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the diverticulum
 What causes it?
Experts aren’t sure about the exact causes of esophageal
diverticula. Some people are born with it, while other
develop it later in life. o rm
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• In adults, it’s often associated with increaseda lP pressure
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within the esophagus. This pressure atio causes the lining to
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protrude in a weakened area.h,Potential causes of this
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increased pressure include:Dani
• malfunction of the sphincters
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esophagus Ab

• inflammation from outside the esophagus

 Cont.…
• food not moving properly through the
esophagus
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• malfunctioning of the swallowingPlatfmechanism
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• It can also be a complicationatiofn
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procedure near the neck,h, Ed
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 How’s it diagnosed?
There are several methods your doctor can use to
diagnose an esophageal diverticulum, including:
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• Barium swallow. You’ll be asked to swallow latf
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a solution
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containing barium, which shows tiup o on an X-ray or CT
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scan. This allows your doctor, to Ed track the movement
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of fluid through your esophagus. ni sh

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• Gastrointestinal endoscopy. For
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this procedure, your
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doctor inserts a thin, flexible tube with a camera at
the end through your mouth and down your throat in
order to view your esophagus.
 Conti..
• 24-hour pH test. This test measures the pH in
your esophagus over a 24-hour period r m to
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check for signs of stomach acid l Pl or bile in your
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 How’s it treated?
There are several treatment options for an esophageal
diverticulum, depending on its size and severity.
Nonsurgical treatment o rm
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• Mild esophageal diverticula can usually a l P be managed
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through lifestyle changes, such as: cati
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• thoroughly chewing your foodish,
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• eating a bland diet h D
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• drinking lots of water after
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Over-the-counter antacids can also help with mild
symptoms.
 Surgical treatment
Surgical treatment
Surgical procedures to do this include: m
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• Cricopharyngeal myotomy. This involves P latf making small
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cuts in the upper sphincter of the ati onesophagus to widen
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it, so food can pass more easily , Ed through your
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esophagus. D an
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• Diverticulopexy with bcricopharyngeal
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myotomy. This
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involves removing a larger diverticulum by turning it
upside down and attaching it to the wall of the
esophagus.
• Diverticulectomy and cricopharyngeal
myotomy. This involves removing rmthe
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diverticulum while performing l aPl atf
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cricopharyngeal myotomy. It’s cati a combination
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that’s often used to treatish, Zenker’s diverticula.
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• Endoscopic diverticulotomy. This
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is a minimally
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invasive procedureA that divides the tissue
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between the diverticulum and esophagus,

allowing food to drain from the diverticulum.
 Are there any complications?
Over time, an esophageal diverticulum can lead to some health
complications.
• Aspiration pneumonia. If an esophageal o rm diverticulum
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causes regurgitation, it can lead to aspiration a l P pneumonia.
This is a lung infection caused by atiinhaling on things, such as
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food and saliva, that usually travel Edu down your esophagus.
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• Obstruction. An obstruction D an near the diverticulum can
make it hard, if not impossible,h to swallow. This can also
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cause the pouch to rupture
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• Squamous cell carcinoma. In very rare cases, ongoing
irritation of the pouch can lead to squamous cell carcinoma.
 Nursing Assessment
1. Obtain history of dysphagia, coughing, throat
discomfort, regurgitation of food.
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2. Evaluate halitosis latf
a lP
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3. Determine what measures cassist ati
o the patient
with food intake; what foods Edu and fluids the
h,
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patient can tolerate. h Dan
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4. Evaluate weight loss
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d and dietary habits.
 Nursing Diagnosis
• Imbalance Nutrition: less than body
requirements related to dysphagia. rm
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• Acute pain related to symptoms a l P and surgical
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 Nursing Interventions
Improving Nutritional status
1. Provide frequent, small meals, which o rm are
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better tolerated. na lP
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2. Elevate head of bed for 2Eduhours after eating.
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3. Monitor intake and output D an
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4. Weight daily Abdu
 Cont.…
Maintaining comfort and preventing
complications
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1. Administer pain medication andPlatfassess
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effectiveness. tio
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2. Patient may need oral suctioning h, Ed to control
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drooling. D an
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3. Instruct the patient
Abdu on importance of good oral

hygiene.
17