Esophageal diverticulitis is a disease characterized by the formation of sacs (diverticula) in the esophagus in which food is trapped causing difficulty in swallowing. Most of the time, this disorder has no symptoms and may not require specific medical attention; however, if your situation is serious, you must see your doctor. Diverticulitis is often caused by other gastrointestinal disorders, such as gastroesophageal reflux or achalasia, and can be treated by addressing the more serious problem. In the worst cases, however, it is necessary to resort to surgery.
Steps
Method 1 of 3: See the Doctor
Step 1. Track your symptoms
Most cases of esophageal diverticulitis are asymptomatic; however, even if you have never had symptoms in the past, the sacs in the esophagus can dilate and over time you may start to experience some discomfort. If your symptoms change, you need to tell your doctor. The typical ailments you may notice are:
- Regurgitation;
- Difficulty swallowing (dysphagia);
- Chest pain;
- Pneumonia;
- Excessive need to clear the throat
- Halitosis;
- Cough;
- Weight loss.
Step 2. Make regular appointments with your doctor
In most cases, this disorder does not need special care; you just have to get checked up for checkups at least once or twice a year to make sure the diverticula have not swollen.
- You should see a gastroenterologist, as he is a specialist in the field and can diagnose and treat esophageal diverticula. You can ask your family doctor to recommend a qualified one; if your situation is quite serious, you should contact a thoracic surgeon.
- If you have an unusual lump in your throat, you should tell your doctor, as it may indicate Zenker's diverticulum.
Step 3. Get tested
There are several tests that your doctor can perform to diagnose this disorder. If it has already been determined that it is esophageal diverticulitis, further tests may be needed to identify the underlying causes and related disorders. Among these exams consider:
- Endoscopy: this procedure must be performed under local anesthesia; the doctor inserts a tube down the throat to examine the type of sacs forming in the esophagus;
- Barium X-ray: you are asked to ingest a liquid similar to gypsum and through a specific x-ray the doctor keeps track of its path along the esophagus to understand if it encounters obstacles;
- Esophageal manometry: a tube is inserted through the throat to measure the contractions of the esophagus and in this way determine if the food passes through it correctly to the stomach;
- 24-hour esophageal pH-metry: a tube is inserted into the esophagus through the nose, while the external part remains attached to the face. During 24 hours, the tube detects the presence of acid produced by the stomach. This test is also used to diagnose a related disorder - gastroesophageal reflux disease (GERD) - which is often the main cause of esophageal diverticula.
Step 4. Learn about antacids
Sometimes they can reduce the symptoms of the disease, especially if the diverticulitis is caused by GERD. Ask your doctor if this class of drugs is appropriate for your situation; do not forget to inform him if you are taking other active ingredients or if you are allergic to certain substances. The antacids that are most often prescribed are:
- Maalox;
- Buscopan Antacid;
- Riopan;
- Gaviscon.
Step 5. Consider having surgery if the situation worsens
If you can no longer swallow without pain, if food enters the respiratory system (you inhale it), or if a diverticulum ruptures, it is necessary to proceed with an operation. Discuss options with your doctor; There are several surgical alternatives to treat the disorder, based on the severity of the situation and the health condition. The most common procedures are:
- Diverticulectomy: ie removal of the diverticulum; this procedure is usually done in conjunction with another treatment or surgery;
- Myotomy: the muscle fiber is cut to relieve pressure on the lower esophageal sphincter; the most common procedures are laparoscopic and cricopharyngeal.
- Endoscopy with CO laser2: consists in the removal of the diverticulum through the laser.
Method 2 of 3: Change the Power
Step 1. Eat a balanced diet
Esophageal diverticula are often caused and aggravated by gastroesophageal reflux disease (GERD), which causes the stomach acids to return to the esophagus, weakening the muscle lining and encouraging diverticula formation. To prevent diverticulitis from worsening, you can reduce gastric reflux episodes by changing your diet. this means limiting spicy, fatty and acidic foods from the diet. You should prefer foods such as:
- Vegetables such as broccoli, kale, and peas
- Legumes, including red beans, black beans and tofu derivatives;
- Lean meats such as chicken, lean ground beef, and fish
- Starches, such as wholemeal bread, rice and pasta.
Step 2. Choose soft foods if you have difficulty swallowing
For some people with esophageal diverticulitis it may be painful or difficult to swallow food; in this case, to maintain a healthy diet you must opt for soft, semi-moist or liquid products that you can take more easily. Preferably choose puree, minced meat or blend the hardest foods to be able to eat them without problems. Here are some good examples:
- Baked sweet potatoes;
- Apple puree;
- Pudding;
- Soft white bread;
- Scrambled eggs;
- Soup;
- Cottage cheese.
Step 3. Drink more water
Water can reduce acid reflux while helping foods flow safely to the stomach, preventing them from getting stuck in the diverticula. Always drink a glass of water after meals.
Be careful not to drink too much alcohol or coffee, as they can increase acid reflux, which in turn aggravates the disorder. alcohol can also weaken the mucous layer of the esophagus, making it more vulnerable to diverticula
Step 4. Rest after meals
It is important that the food reaches the stomach without being "disturbed". To avoid the risk of regurgitation, you should rest after each meal, sitting with your back and neck straight; if it is easier for you, you can also remain standing. Avoid engaging in too strenuous physical activities and do not lie down; allow yourself at least half an hour of rest.
Method 3 of 3: Prepare for Surgery
Step 1. Stop smoking four weeks before surgery
If you are a smoker, you must stop smoking at least one month before entering the operating room. As it can be a difficult step for many people, you should start as soon as the surgery date is set.
- If you start early enough, you can make cigarette withdrawal more bearable by using nicotine gum or patches, which you must stop using within 1-4 weeks of the procedure, as nicotine can interfere with surgery.
- Get rid of all cigarettes in your home, car, and office to reduce your chances of smoking again before you undergo the operation.
- To increase your chances of success, you can join a group to find support and advice.
Step 2. Discuss your medications with your doctor
It is important for your doctor to know which active ingredients you are taking before undergoing the surgery, including dietary supplements and other over-the-counter medications. Sometimes it is necessary to stop taking them for up to a week before surgery, as they may interfere with anesthesia, cause blood clots, or make any medications you take after surgery harmful or ineffective.
- Stop taking non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen sodium or ibuprofen, before the operation. If you are taking aspirin for heart problems, talk to your doctor about what to do. you can continue taking acetaminophen instead if needed.
- You must stop using blood thinners, such as heparin or warfarin (Coumadin), until you are cured of the surgery.
- Herbal supplements and medications may also interfere with the operation; therefore inform your doctor of all products, herbal remedies and natural treatments you are using.
Step 3. Start a liquid diet
If you are undergoing a laparoscopic myotomy, your doctor will instruct you to start consuming only liquid foods three days before the operation; this means you can only eat clear soups and broths, juices, jellies, sports drinks, and dairy-free coffee or tea. You cannot eat any solid food.
If you are undergoing a myotomy of the cricopharyngeal muscle, you can eat until midnight the day before the procedure; however, always ask your surgeon for confirmation before taking any action
Step 4. Tell your doctor if any complications arise
It is quite normal for some swelling or pain to develop around the incision site, but most of the time this type of surgery is non-invasive and you should heal within a few days. However, if you have the following symptoms, seek immediate medical attention:
- Fever over 38.5 ° C;
- Chills;
- Difficulty in breathing
- Yellow pus escaping from the incision site;
- Bad smell coming from the incision site;
- Increased pain.
Step 5. Take medications as recommended
You may experience pain after the operation. During the first few days, when you are taking painkillers, you shouldn't drive or go to work; ask a friend or family member to take care of you during this recovery period.
Step 6. Stick to a liquid diet during the healing process
After the operation, you cannot eat solid food until the incision has healed; at this stage you should only consume liquid substances or foods that you have softened by blending them or turning them into puree.
- Some great solutions for your situation are beef broth, apple puree, juices, popsicles, and jellies.
- Don't drink alcohol until you are completely healed.
Advice
- The best way to treat esophageal diverticula is to intervene on the underlying problem that is responsible for it; for most people, this means treating GERD or achalasia.
- Although an increase in fiber intake can reduce bowel problems, it is not known whether it can also prevent it.
Warnings
- A serious side effect of the presence of esophageal diverticula is the aspiration of food (when it enters the respiratory system rather than the digestive system); if you have difficulty breathing, see your doctor as soon as possible.
- Always follow your surgeon's directions to prepare for surgery, as specific and individual circumstances may require a particular diet, medication, and amount of rest both before and after the operation.
