Throat pouch is one cause of bad breath
DEAR DR. DONOHUE: Through the years you have addressed the problem of bad breath more than once. Usually you do not mention the possibility of it being caused by a Zenker’s diverticulum. This was my husband’s problem. An emergency-room trip for a chunk of chicken stuck in his throat finally solved the problem. Our ENT doctor didn’t encourage him to have the diverticulum surgically removed. After several years, he decided to see another doctor and had the surgery. We both regretted his not having had it done sooner. It was wonderful. He could eat without coughing or choking; he was able to gain back the weight he had lost; and his breath was fine. I hope you’ll mention something about Zenker’s diverticulum. — V.E.
ANSWER: A diverticulum is a small pouch. In the case of a Zenker’s diverticulum, the pouch protrudes from the back of the throat and adjacent part of the swallowing tube, the esophagus. This kind of diverticulum is much larger than the colon diverticula found in diverticulosis.
Zenker’s diverticulum forms later in life. People with one often complain that food sticks in their throats. It’s actually stuck in the diverticulum. There it undergoes digestion. Later, the partially digested food can be regurgitated from the diverticulum back into the mouth. This is what causes bad breath. Coughing and choking while eating are other signs of a Zenker’s diverticulum.
The diagnosis is made by having X-rays taken while the patient swallows barium, thick material that stands out impressively on an X-ray picture.
Nowadays, surgical removal of a Zenker’s diverticulum can often be accomplished through relatively small incisions, and the pouch is removed with the aid of special instruments and a scope. And sometimes the diverticulum can be removed without any incision, the scope being passed down the throat.
I do have to caution people. Halitosis is common. A Zenker’s diverticulum is somewhat rare.
TO READERS: A little while back I had a question about eating shrimp shells. I knew nothing about that custom and asked readers to respond. They did. I thank all of them for taking the time to do so. Here are some replies:
In the early 90s, I saw a TV cooking show and the cook said to eat shrimp shells for their nutritional value. So I tried it, and nothing bad happened to me. — D.P.
I am writing to answer the shrimp shell eating question. My wife, who is Japanese, says that she and many Japanese eat the shells. She says they are very tasty and a good source of calcium. — G.G.
I have been eating shrimp shells for decades. Mostly I eat them because that is where the flavor of the boil seasoning is. My dad did this, as do most of my brothers. I am a 50-year-old female and had my first colonoscopy. I got a good report. I love the shells. — D.B.
On the beach at Ipanema and Copacabana, they sell cooked shrimp over a fire and on a stick. Lots of people eat the whole shrimp, shell and all. — W.S.
RESPONSE: I guess it’s safe to eat the shells. I’m not endorsing the practice, and I don’t intend to adopt it.
DEAR DR. DONOHUE: I have a question about hair. What causes gray hair? I am 80 and do not have any gray hair. People ask me why I have it dyed. I would like to have a scientifically backed answer for them. — P.B.
ANSWER: Pigment cells at the bottom of a hair follicle impart color to hair. Those cells are called melanocytes. With age, the cells produce less pigment. Hair with little pigment is gray. Hair with no pigment is white.
Genes, as they always do, have a role in the demise of pigment production. I’ll bet one of you parents had hair that was still naturally colored in old age.
Pluck a few hairs and carry them with you for inquirers. Ask them to submit the hair for analysis and if no dye is found, they owe you $20.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


Only subscribers are eligible to post comments. Please subscribe or login first for digital access. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.