What is Zenker's Diverticulum?

Zenker's diverticulum is a disorder that most commonly affects older adults. The actual name refers to development of a pocket or diverticulum (pouch) in the throat. This is right below where food is swallowed, and since it builds a supply of food in the pouch each time food is consumed, it can create many different problems, including making it difficult for food to proceed down the esophagus and when full, having the food reemerge into the throat at odd times to create choking and coughing.

The symptoms of Zenker's diverticulum, then, include coughing and choking at night especially, a sensation that food will not pass down or be able to be swallowed, getting old food previously consumed into the upper throat, often many hours after consumption, and sometimes lack of effectiveness of medications taken. This last can occur because the medications are stuck in the pocket and haven’t reached the stomach where they can be broken down and distributed to the body as necessary. Such symptoms are always a reason to see a doctor to determine the underlying issue, though when people first develop this condition symptoms may only occur occasionally.

A doctor may have several methods for diagnosing Zenker's diverticulum. These could include x-rays that use barium to find the pocket. Other methods that might be employed are x-rays alone, others scans or bronchoscopy, which can look at the throat to find any abnormalities.

Sometimes when Zenker's diverticulum is first diagnosed symptoms are very mild, but for many people, the pocket will widen with time resulting in far more frequent appearance of disturbing symptoms. Doctors typically make the suggestions that treatment of Zenker's diverticulum will ultimately need to involve a surgical procedure to either cut off or staple down the pocket and close its connection with the rest of the throat.

There are several ways surgery for this condition could be performed, and they may depend on doctor and/or patient preference. The decision usually rests ultimately with the patient and there are two common methods by which Zenker's diverticulum can be removed. The first is an operation on the throat, that cuts into the throat and either cuts out the pocket or staples it shuts. Alternately, a surgeon can access the throat via the mouth through what is called an endoscope or several of them. These devices can then be used to close the diverticulum. Endoscopic procedures tend to be gaining in favor, are just as likely to work as open procedures, and typically have quicker recovery time, so they are fast gaining as the more popular approach.