Finding relief after years of digestive issues (video)

For years, Jeff Johnson thought he was simply living with chronic acid reflux. A construction supervisor in his 60s, Jeff had grown accustomed to discomfort after meals — regurgitating food, coughing and sleeping upright to avoid symptoms.

“I’d eat breakfast at work — just something simple like an English muffin and eggs — and minutes later, I’d be coughing and spitting up food,” Jeff says. “It was food that had never made it to my stomach.”

Initially diagnosed with gastroesophageal reflux disease (GERD) at 40, Jeff spent decades managing his symptoms with medication. But when his symptoms worsened, he sought a second opinion — a choice that changed everything.

Discovery of a rare condition

Jeff’s new primary care doctor referred him to Dr. Sergio Flores, a gastroenterologist with Sharp Community Medical Group and affiliated with Sharp Memorial Hospital. Dr. Flores ordered a special X-ray that captures real-time swallowing, which revealed Zenker diverticulum, a rare condition in which a pouch forms in the upper esophagus, trapping food and fluids.

“Zenker diverticulum is caused by a muscle that fails to relax properly when we swallow,” explains Dr. Michael Lajin, an interventional gastroenterologist with Sharp Community Medical Group and affiliated with Sharp Grossmont Hospital. “That creates pressure and forms a pouch where food can collect. It can cause regurgitation, coughing, hoarseness or even aspiration.”

In Jeff’s case, the pouch measured over six centimeters and had likely taken years to develop. “It turns out I’d probably been living with this for a very long time,” Jeff says. “I just didn’t know what it was.”

Z-POEM provides immediate relief

Dr. Flores referred Jeff to Dr. Lajin, one of the few physicians in the region trained to perform Zenker peroral endoscopic myotomy, also known as Z-POEM, a minimally invasive alternative to traditional surgery. Rather than making an incision in the neck, Dr. Lajin uses a flexible endoscope inserted through the mouth to cut the malfunctioning muscle and relieve the blockage.

“Z-POEM is part of what we call ‘third space endoscopy,’” says Dr. Lajin. “It allows us to access and treat the inner layers of the gastrointestinal wall without surgical incisions. Patients typically go home the next day and experience rapid symptom relief.”

Jeff says the difference was immediate. “I had the surgery on a Monday and was home by Wednesday,” he says. “There was no pain, just a little discomfort at first when swallowing. But once I healed, everything changed.”

Rewarding for patients — and providers

Jeff no longer regurgitates food and is able to sleep flat for the first time in years. What’s more, his heartburn is gone.

“I feel 100% normal,” Jeff says. “I haven’t had a single issue since.”

Dr. Lajin notes that many patients with Zenker diverticulum are misdiagnosed for years and often treated for reflux or respiratory issues. “This condition isn’t widely known, even among providers,” he says. “We want patients to know that if they’re experiencing unexplained regurgitation or swallowing problems, there are effective, noninvasive treatments available.”

Sharp Grossmont Hospital was the first nonsurgical gastrointestinal department in San Diego to offer Z-POEM, and Dr. Lajin has been involved in national studies to help advance its use.

“This is one of the most rewarding procedures we do,” says Dr. Lajin. “Patients recover quickly, and for many, like Jeff, it truly restores their quality of life.”

Watch the above video to learn more about Jeff and the Z-POEM procedure.

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