Figure 1: Example of an X-ray demonstrating the presence of a Zenker’s diverticulum. This is a neck X-ray taken from the side, while the patient was drinking barium (which appears bright white). As the barium is ingested, it can be seen that the patient has a pouch located just behind the normal esophagus.

A Zenker’s Diverticulum is a specific abnormality that occurs in the lower throat. In this disorder, a pouch is formed alongside the esophagus, which may accumulate food or liquid. As the pouch fills, the contents are regurgitated into the throat, leading to symptoms of dysphagia and/or aspiration. The pouch progressively enlarges over time, as it is stretched by food. Zenker’s Diverticula are typically found in older individuals, and are often problematic because they may interfere with proper dietary intake or may lead to pneumonia.

Zenker’s Diverticula are caused by an abnormality in the function of the upper esophageal sphincter muscle, known as the cricopharyngeus. This muscle normally opens during a swallow to allow food and liquid to enter the esophagus. If the muscle is too tight, and does not open, it may force food to push against a weak segment of the lower throat. As time passes, this may lead to the development of a pouch.

Treatment of Zenker’s Diverticulum has traditionally consisted of surgical removal through a neck incision along with cutting of the cricopharyngeus muscle. Such surgery requires patients to stay in the hospital for several days and to not eat until the area heals. This may be for up to ten days after surgery. More recently, minimally invasive techniques have been developed that allow faster recovery and surgery without neck incisions. Patients undergoing endoscopic surgery for Zenker’s Diverticulum typically stay in the hospital overnight, and are allowed to eat the following day. However, this type of procedure may not be possible for every patient, and the advantages and disadvantages may vary on an individual basis.