Gender Ethnicracial And Life Span Considerations

Infants and children have been known to have esophageal diverticula, although the disorder predominantly occurs in adults beyond midlife. It affects men three times as often as women. Epiphrenic diverticula usually occur in middle-aged men. Zenker's diverticulum occurs most often in men over the age of 60. There are no known racial or ethnic considerations.

Esophageal DRG CategĀ°>r

Mean LOS:

Diverticula

Description:

DRG Category: Mean LOS: Description:

338 Esophageal Diverticula

^ ASSESSMENT

HISTORY. Establish a recent history of weight loss, which is generally attributed to difficulty in eating. Determine if the patient has experienced subtle, gradually progressive esophageal dysphagia that primarily affected the swallowing of solid foods. Ask if the patient has experienced gagging, gurgling, or a sense of fullness in the throat as if something were "stuck." Inquire whether the patient has regurgitated food particles and saliva soon after eating. Determine if the patient has experienced an unpleasant taste and nocturnal coughing with regurgitation of retained secretions and undigested foods. Establish a history of heartburn following ingestion of coffee, alcohol, chocolate, citrus juices, or fatty foods, particularly when the patient was bending over or lying down within 2 hours of intake. These indicators suggest that the esophageal diverticula are secondary to achalasia.

PHYSICAL EXAMINATION. Assess the patient's appearance, noting apparent weight loss or the malnourished look that is associated with anorexia. Note halitosis, a common sign of esophageal diverticula. Inspect the patient's neck for visible signs of esophageal distension that has been caused by food trapped in the diverticula.

PSYCHOSOCIAL. The patient may experience self-imposed social isolation because of feelings of embarrassment, which are caused by noisy swallowing, unusual facial expressions during eating, or halitosis. The patient may become depressed because of the loss of pleasure and socialization connected with eating, along with grieving over the loss of dietary preferences. The patient's family may be anxious about the social effects of the patient's disease as well.

Diagnostic Highlights

Test

Normal Result

Abnormality with Condition

Explanation

Esophageal manometry

Multilumen esophageal catheter is introduced through the mouth, and pressures along the esophagus are measured during swallowing: normal contractions, swallowing, peristalsis

Abnormal contractions, swallowing, and peristalsis

Assesses and diagnoses dysphagia, esophageal reflux, spasm, and motility abnormalities, hiatal hernia

Barium swallow

Normal esophagus

Identifies irregular or abnormal areas of the esophagus

Locates and describes irregularities in the esophageal wall

Esophagoscopy

Visualization of a normal esophagus

Direct visualization of diverticula

Locates esophageal diverticula

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