Disorders of the gastrointestinal tract today inMedicine is diagnosed very often in people of both sexes and different age groups. One of the pathologies that is observed in 2% of people all over the world is the diverticulum of the esophagus, which is characterized by the saccular protrusion of its wall, which communicates with the lumen. Often this disease becomes the cause of esophagus suppuration, the occurrence of bleeding and narrowing of the lumen, the appearance of fistulas and the formation of cancer tumors. Pathology is usually accompanied by other diseases of the digestive tract, such as a stomach ulcer or duodenal ulcer.
Description of the problem
Esophagus diverticulum - pathological processdeformations of the esophagus walls, protrusion of its layers towards the mediastinum in the form of a sac. In gastroenterology, such a protrusion is diagnosed in 40% of cases, most often in men after 50 years. The disease is usually accompanied by cholecystitis, a stomach ulcer or other diseases.
The diverticulum of the esophagus, the ICD code has K22.5 and Q39.6, which includes congenital and acquired diverticula. With late treatment of the disease, complications develop, in particular, necrosis and inflammation of the sac, its rupture.
Образование дивертикулов может развиваться в cervical, thoracic or abdominal esophagus, but most often the pathology is localized in the chest. There is also a Zenker diverticulum located in the pharyngeal-esophageal part of the organ.
Stages of the disease
The disease goes through three stages of development:
- The first stage, in which there is a protrusion of the epithelium of the esophagus through the weak points.
- The second stage is characterized by the formation of a sac that is localized between the spine and the esophagus.
- The third stage is caused by an increase in the size of the sac that can descend into the mediastinum and become an extension of the esophagus. In severe cases, the bag may contain up to one and a half liters of liquid.
Esophagus diverticula: classification
In medicine, it is customary to distinguish the following types of pathology:
- A true diverticulum is characterized by protrusion of the walls of the organ in the form of a sac, which consists of the muscular, mucous, and outer layers.
- False diverticulum is caused by protrusion of the wall of the body as a result of pathology in the muscle layer, so the bag in this case consists only of the mucous membrane and the outer shell.
By origin, the disease is congenital,formed in the prenatal period as a result of abnormal development of the fetus, and acquired. The latter species, in turn, is subdivided into traction, which is formed due to regular stretching of the walls of the organ; pulsary when the tumor develops under the influence of external factors; combined. Also, diverticula can be single (90% of cases) and multiple (10% of cases).
Causes of the disease
The diverticulum of the esophagus causes canhave different. Congenital abnormality is formed due to abnormal development of the esophageal wall in a certain area, in which its muscular layer is weak.
Acquired pathology occurs as a result of inflammatory processes of the gastrointestinal tract and mediastinum. The provoking factors in this case include:
- Gastroesophageal reflux disease (GERD) and esophagism.
- Esophagitis and tuberculosis.
- Inflammation of the lymph nodes.
- The presence of infections in the esophagus.
- Injuries and strictures of the esophagus.
- The accretion of the walls of the body.
Pulse diverticulum forms with increasingpressure in the body, due to protrusion of its wall. Typically, this phenomenon is observed in the stenosis of the esophagus or in the disorder of its motility. Traction diverticulum appears due to the fusion of the esophagus wall with the internal organ, which pulls it towards itself, forming a protrusion. This phenomenon can be observed during the development of the inflammatory process.
Symptoms and signs of the disease
Usually, the esophagus diverticulum symptoms manifestsdifferently, depending on the location of the pathological area. The brightest signs are shown by Zenker's diverticulum. In this case, the passage of food through the esophagus is difficult. It accumulates in the bag, a person periodically spits up undigested food, he has a putrid breath, a sore throat, a lumpy sensation, a dry cough. This pathology is accompanied by nausea, a change in timbre of the voice, redness of the face, suffocation, dizziness, and loss of consciousness. Such phenomena usually disappear after vomiting.
Small esophageal diverticula symptoms usuallydo not show. When the pathology of the lower esophagus is observed shortness of breath, bronchospasm, tachycardia, pain in the heart. Often, diverticula are accompanied by the formation of fistulas, neck phlegmon, sepsis, bronchitis, pneumonia or lung abscess.
Complications and consequences
If untreated, this pathology canlead to suppuration and perforation of the diverticula, resulting in bleeding. The appearance of fistulas and oncologic neoplasms in the esophagus is also possible. Often the complication is aspiration pneumonia, pleurisy and abscess of the lungs, as well as angina and arrhythmia, mediastinitis.
The most common complication of the disease isdiverticulitis - inflammation in the neoplasms as a result of their defeat by pathogenic bacteria, as well as accumulations of food debris that begin to rot. Therefore, if the signs of such a pathology as esophageal diverticulum appear, clinical recommendations will be directed to strict adherence to all prescriptions during therapy.
Diagnosis of the disease
When diagnosing, the doctor first examineshistory of the disease, conducts examination and questioning of the patient. Then the doctor prescribes X-rays to determine the location of the pathological area, the width of its neck, as well as the presence of other entities, such as polyps or cancer.
The doctor also prescribes the following diagnostic methods:
- CT scan of the chest.
- Esophagoscopy to examine the cavitydiverticulum, epithelium deformities, the presence of bleeding, tumors. When using this technique, a biopsy is often performed. Biological material after the procedure is sent for histological examination.
- Esophageal manometry to study esophageal motility.
- ECG, echocardiography, Holter monitoring in the case of coronal symptoms.
- Laboratory blood tests.
The doctor differentiates the diverticulum of the esophagus with suchdiseases such as GERD, esophageal strictures, cancer, cystic neoplasm in the mediastinum, angina pectoris, coronary artery disease, and esophageal hernia, esophagism. Other diagnostic methods may be used for this. After a comprehensive examination, a treatment plan is developed in each case.
Pathology therapy
Treatment of the esophagus diverticulum is not carried out onlyin the event that he does not bother the person. The patient is under observation and is periodically examined to monitor the development of the pathology. It is possible to prescribe medications that help to eliminate the problem. Often, doctors prescribe antibacterial drugs, antacids, secretolytics and prokinetics.
Обязательно врачом назначается щадящая диета при esophagus diverticulum. In this case, spicy dishes and alcohol are excluded from the diet. All products must be steamed or in the oven. It is also recommended to consume a large amount of pure water per day, and after eating food, flush the esophagus with an antiseptic solution. People with this disease must follow certain rules to improve the diversion of the diverticulum.
People who are at risk are oftenundergo electrocoagulation and laser therapy. With the help of special equipment it is possible to restore the space between the sacs, normalize the lumen of the esophagus. Such treatment is carried out in a hospital.
Surgery
If there is a high risk of complications,also when a large-sized diverticulum of the esophagus is performed without fail. Most often, doctors cut off the tumor and suture the esophagus. Sometimes it is required to perform plastics on the walls of an organ with material taken from the pleura or diaphragm. All operations are performed under local anesthesia. After surgery, patients are under the supervision of a physician for a long time. In case of feeling unwell after the operation, an increase in body temperature, they speak about the development of complications that must be eliminated. After surgery, the patient should be under the supervision of a physician, undergo control tests.
The operation can also be carried out in the case when the patient himself expressed a desire to get rid of this problem.
Обычно операция осуществляется через шейный отдел or chest, depending on the location of the bag. The type of surgical intervention is determined by the attending physician depending on the symptoms of the disease, the localization of the formation and the general condition of the patient.
After surgery, the development of suchcomplications such as mediastinitis, failure of a surgical suture, nerve paresis, wound infection. Therefore, shortly before and after the operation, antibacterial drugs are prescribed.
Alternative medicine
Лечение дивертикула пищевода народными средствами is acceptable only as an additional method of therapy and after consultation with a specialist. Typically, traditional methods are used to eliminate the symptoms of the disease. In this case, it is recommended to cleanse the intestines with a special diet, which includes cereals from germinated millet and apples. This diet must be followed for 20 days. Also during this period, you can eat bran, drink liquid kissel based on oats. To eliminate the inflammatory process is well suited dogrose infusion, dill seeds or decoction of chamomile. It must be remembered that traditional medicine can not replace the main treatment.
Forecast
Обычно дивертикул пищевода имеет благоприятный prognosis, after surgery, it is possible to completely eliminate the pathology and all unpleasant symptoms. If there are complications, the prognosis will be less “good”; therefore, even asymptomatic disease requires diagnostic measures. In the most severe and neglected cases, death is possible. Self-treatment of pathology is not recommended, as unpleasant consequences can develop, which will be hard to eliminate.
Prevention
In order to prevent physicians recommendtimely conduct therapy of diseases of the digestive tract, eat food slowly, chewing it thoroughly. It is also necessary to exclude from the diet strongly hot or cold dishes, eat while sitting, eliminate snacks on the go, as well as avoid injury to the esophagus and carry out dietitian appointments.
Дивертикул пищевода сегодня встречается в Gastroenterology is quite common. This pathology may be congenital or acquired. Often, refusal of treatment and non-observance of a healthy lifestyle leads to the development of complications that can cause significant harm to human health. Today, the disease can be cured in many ways, but it is important to prevent the development of complications, so it is recommended to do it in a timely manner. If you find unpleasant symptoms of the disease, you should immediately contact a medical institution, it is not recommended to engage in self-treatment.
