What is Zenker’s diverticulum?
Zenker’s diverticulum, also known as pharyngoesophageal diverticulum, is a pharyngeal pouch that forms where the lower part of the throat and the upper part of the esophagus meet.
It is most common in older adults. If left untreated, it can negatively affect quality of life and can put a person at increased risk of aspiration and choking.
Zenker’s diverticulum symptoms
A person with Zenker’s diverticulum may experience:
- Difficulty swallowing
- Bad breath
- Chronic cough
- A feeling of excessive phlegm or mucus in the throat
- The sensation of “a lump in the throat”
- Regurgitation of food (often hours after a meal)
- Weight loss because eating is difficult
Causes of Zenker’s diverticulum
Zenker’s diverticulum develops when the muscle between the throat and esophagus, known as the cricopharyngeus muscle, over-tightens, causing the throat above it to pouch out. Overtime, the pouch can enlarge as the muscles below it tighten excessively. Food can catch in this pouch or it can cause an obstruction. It can also make it difficult to take medications – particularly pills, which could get caught.
Diagnosing Zenker’s diverticulum
When diagnosing Zenker’s diverticulum, swallowing specialists at the Penn Center for Voice, Speech and Swallowing will begin with a review of your symptoms and medical history.
Diagnostic endoscopy is an outpatient procedure performed to view the top of the esophagus and surrounding structures. It takes less than 5 minutes and is performed with local anesthetic.
Zenker’s diverticulum treatment options
The Penn Center for Voice, Speech and Swallowing offers the full range of treatments available for Zenker’s diverticulum.
For individuals with mild cases, changes to your diet and eating habits, such as drinking water after meals or chewing food thoroughly, may be beneficial.
Endoscopic Zenker’s diverticulum surgery is recommended for severe cases. During this procedure, the cricopharyngeal muscle is cut using a laser or stapler. This eliminates the pouch and allows food to pass through when swallowed. Surgery can be performed using either a minimally invasive or open approach. You will go home the same or next day.
Medications, such as Botox, may provide temporary relief for Zenker’s diverticulum measuring less than 1 cm or for individuals who aren’t eligible for surgery.