Pharyngeal Pouch/ Zenkers Diverticulum
What is Pharyngeal Pouch/ Zenkers Diverticulum?
Pharyngeal Pouch/ Zenkers Diverticulum is a condition where the oesophagus bulges and creates an abnormal pouch or pocket in the food pipe. It is caused by tightening in the upper oesophageal sphincter; the pouch (or diverticulum) is formed just above (when the muscle tightens and there is increased pressure while swallowing food).
Food and drink can become trapped in the pouch causing unpleasant symptoms such as difficulty swallowing, the feeling of food sticking in the throat, bad breath, choking, coughing and regurgitation/vomiting of food. Sometimes eating and drinking becomes so uncomfortable that the person loses weight unintentionally.
Zenker’s affects around 1 in 1,000 people. It is more common in men and those aged over 40 – and it is much more common in the over 70s. Read about Martin’s experience of living with Zenker’s Diverticulum here.
Diagnosing Zenker’s Diverticulum
In the past, Zenker’s was thought to be rare. However experts now believe that it is far more common, as many cases go undiagnosed. Patients may go to their GP complaining of chronic cough, problems swallowing or bad breath, but may be misdiagnosed as heartburn or indigestion. Elderly patients are sometimes told their symptoms are a ‘normal’ part of ageing.
A gastroenterologist is the best doctor to investigate swallowing issues and there are a range of options to diagnose (or rule out) Zenker’s Diverticulum.
Patients may be offered an upper endoscopy where a camera is inserted on a long thin tube to examine the throat and oesophagus. Patients may also be offered a Barium swallow survey which allows their gastroenterologist to investigate swallowing problems more closely.
Treating Zenker’s Diverticulum
Up until recently the only treatment for Zenker’s Diverticulum was open surgery (under general anaesthetic) performed via incisions in the throat. During the surgery a stapling tool is inserted through this cut which uses staples to close the pouch. However the operation risks infection and bleeding risk, making it unsafe for many elderly patients. What’s more, the staples can loosen over time, causing the pouch to re-form.
Dr Haidry was the first to introduce a pioneering new endoscopic procedure called Zenkers Peroral Endoscopic Myotomy (Z-POEM). It’s minimally invasive, making it a preferred option for a condition which is more common in elderly patients.
Why Z-POEM?
Z-POEM is an endoscopic procedure (performed via a tube down the throat), which means it’s incisionless (no cuts to the neck/throat) and less risky than surgery.
Z-POEM involves making a small incision in the lining of the oesophagus where the pouch starts. This allows the endoscope to find the thick muscle (septum) that separates the pouch from the oesophagus. Using a small knife this muscle is divided and cut so that the pouch becomes one with the oesophagus (and the sac is no longer present).
The procedure itself takes half an hour and patients can go home after 24 hours. Studies show the operation is more effective than the previous method and results in fewer side effects. It is a very safe and targeted procedure compared to the surgical options, allowing patients a quick recovery and long lasting improvements in their symptoms. Learn more about Z-POEM here.
In The News
Dr Rehan Haidry talks about Zenker’s Diverticulum and the latest treatment options:
See Daily Mail article here.
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org