NHS introduces scalpel-less surgery to cure bad breath and swallowing problems for thousands of Zenker’s diverticulum patients

Thousands of Britons with a nasty throat condition that causes bad breath and difficulty swallowing could be cured with 30-minute scalpel-free surgery.

The only current treatment for the problem called Zenker’s diverticulum, where food debris gets stuck in pouches of tissue in the gullet (esophagus), has been to remove the tissue through an incision in the throat. But NHS bosses have now approved a new technique which involves shaving off tissue with instruments inserted through the mouth into the gullet.

Experts say it could cure many more patients with the condition, which usually affects older adults.

“There are many older people living with untreated Zenker’s disease,” says Dr. Rehan Haidry, specialist in gastroenterology at University College London Hospital and the first British doctor to perform the operation on the NHS.

“Many are refused surgery because it is considered too risky, but this new method, which is simple and cheap, will reduce the number of patients in the UK.”

Zenker’s diverticulum affects around 3,000 Britons, usually as a result of weakened neck muscles.

Due to the relaxed muscles, tissue folds in the upper part of the esophagus form a so-called pharyngeal pouch.

Food and liquid get trapped here, which then leads to a build-up of bacteria that causes bad breath and difficulty swallowing when you eat. Symptoms vary depending on how deep a pouch has formed.

In extreme cases, patients often choke while eating and suffer from a chronic cough. In some cases, Zenker can cause life-threatening aspiration pneumonia – an infection of the lungs caused when food, saliva or other solid particles are inhaled into the lungs.

In the past, Zenkers were considered rare. However, experts believe it is much more common as many cases go undiagnosed.

Dr Haidry says: “Patients often go to their GP with complaints of a terrible cough, difficulty swallowing or very bad breath, but their doctor will dismiss it as part of old age. According to our estimates, Zenker’s actual figures are twice as high as previously assumed.”

The current procedure is performed under general anesthesia and requires an incision in the throat. A stapling tool is placed through this incision and used to seal the pouch. However, the operation carries the risk of infection and bleeding, making it unsafe for some at-risk patients. Dr. Haidry says, “You end up with patients who have been in excruciating pain for years without treatment.”

Over time, the clips can also loosen, causing the bag to deform.

Many older people with Zenker’s disease are not offered traditional surgery because the risks outweigh the potential benefits

The new procedure is also performed under general anesthesia, but involves threading a tube down your throat until it reaches the sac. A small surgical blade is attached to the end of the tube, and the surgeon uses a camera to cut away the excess tissue.

The procedure usually takes half an hour and patients can go home the same day.

Studies show that the operation is more effective than the previous method and results in fewer side effects.

It is currently only offered at University College Hospital in London, but experts say more NHS trusts will use it next year. “It is affordable and very easy for surgeons to learn,” adds Dr. Haidry added.

One of the first NHS patients to benefit is Martin Smith, 82, from London, who received treatment in September. In June, the former surveyor started having trouble swallowing his food.

“Just about every time I took a bite, I felt like I was choking,” says Martin. “It also affected my breathing. It was embarrassing and made eating very difficult.”

His family doctor sent him for an X-ray, which showed that a pouch had formed in his throat. He then went to Dr. Transferred to Haidry.

Martin went to the hospital in the morning, was operated on at 16:00 and was out for an overnight stay.

“Since then my throat has really improved,” he says. “It was quite painful for a few days, but it’s gone now and I’m eating solid food again without any problem.”