Zenker’s Diverticulum

What is Zenker’s diverticulum?

A Zenker’s diverticulum is an issue that affects your throat (pharynx). It’s a pouch that forms at the bottom of your throat where your throat connects to your esophagus. The pouch traps food, making it hard for you to swallow. Zenker’s diverticulum typically affects people aged 70 to 90. You may have this condition for years before you develop noticeable symptoms, and it doesn’t go away on its own. Healthcare providers treat Zenker’s diverticulum with surgery.

Is Zenker’s diverticulum a common condition?

No, it’s not. Studies estimate about 2 in 100,000 people develop this condition.

What are symptoms of Zenker’s diverticulum?

Zenker’s diverticulum may not cause symptoms unless a pouch grows so large that you have trouble swallowing food. Typically, pouches are a few centimeters in size.

The most common symptom is dysphagia (difficulty swallowing). Other symptoms may include:

• Hoarseness (dysphonia).
• Bad breath (halitosis).
• Regurgitating swallowed food.
• Aspiration pneumonia.
• Feeling there’s phlegm in your throat.
• Unintended weight loss because you have trouble swallowing food.

What causes Zenker’s diverticulum?

Researchers don’t know the exact cause but think issues with your cricopharyngeus muscle are to blame. This muscle is at the top of your esophagus. It opens (relaxes) to let food in and then closes. When you swallow food, powerful muscles in your throat push food down toward your cricopharyngeus muscle. When this muscle doesn’t relax as it should, food gets caught in a muscular squeeze play that puts pressure on your pharynx wall. Over time, the pressure pushes tissue through the wall to make a pouch.

What are the risk factors?

Risk factors for developing Zenker’s diverticulum include:

• Age. (Zenker’s diverticulum typically affects people ages 70 to 90.)
• Gender. (Men and people assigned male at birth are more likely to develop the condition than women and people assigned female at birth.)
• Issues with how your esophagus works. (Esophageal motility disorder)

What are the complications of Zenker’s diverticulum?

Potential complications include aspiration pneumonia and malnutrition.

How is it diagnosed?

Healthcare providers may do the following tests to diagnose Zenker’s diverticulum:

• Esophagram test.
• Upper endoscopy.
• Esophageal manometry.

What is the treatment for Zenker’s diverticulum?

That depends on your situation. If Zenker’s diverticulum causes serious complications like malnutrition or aspiration pneumonia, or it causes other bothersome symptoms, your healthcare provider may recommend surgery.

What surgeries treat this condition?

Zenker’s diverticulum surgery involves removing, moving or altering the pouch in your throat so it doesn’t trap food. You may have open or endoscopic surgery.

Open surgery is making incisions (cuts) in your throat. In endoscopic surgery, healthcare providers use instruments that give them access to the pouch in your throat by going through your mouth. Your surgeon will evaluate your situation and recommend which surgery makes sense for you.

What’s the recovery time after Zenker’s diverticulum surgery?

Most people recover within a few days to a couple of weeks. Your surgeon will explain what you can expect, but the recovery process typically includes:

• Staying in the hospital for at least a day, up to several days.
• Needing a temporary feeding tube in your nose while your surgical site heals.
• Being on a liquid or soft diet for up to two weeks after your surgery.

What are surgery complications?

Open and endoscopic surgery have similar potential complications:

• Bleeding.
• A leak or hole in your esophagus.
• Infection of your neck or chest (mediastinitis).
• Injury to your lips, teeth, tongue or gums from endoscopic surgery.
• Hoarseness from injury done to the nerve to your larynx (voice box) during open surgery.

What’s the outlook for Zenker’s diverticulum?

The outlook is good, but Zenker’s diverticulum may come back after surgery. That’s because the condition happens when there’s an issue with how your throat muscles work.

How do you swallow if you have Zenker’s diverticulum?

Zenker’s diverticulum can make it hard for you to swallow food. You may feel like food is getting caught in your throat. Here are some steps that may help move food past the pouch:

• Take small bites of food.
• Chew each bite very thoroughly.
• Sip water between bites of food.

What foods should you avoid if you have Zenker’s diverticulum?

You can eat most foods if you remember to chew each bite thoroughly. In general, you should avoid foods that could get caught in the pouch, like food with:

• Skins, like apples, potatoes and tomatoes.
• Seeds.
• Nuts.

Why is it called Zenker’s diverticulum?

The condition is named after Friedrich Albert von Zenker, a German pathologist and doctor. In 1877, he published articles in 1877 about his experience treating people who have it.