In rare cases, patients — usually over age 70 — experience a malfunction in one of the muscles of the mouth, throat and esophagus that are needed to swallow. Related to age, this leads to a build-up of pressure that causes a weak part of the lining to bulge out like a pouch for a condition called Zenker’s Diverticulum.
It’s not a common condition, affectingly just two in every 100,000 people, mostly men and those assigned male at birth. If untreated, the pouch can grow large enough to collect food, posing an even greater swallowing challenge plus concerns about malnutrition or inhaling food.
Symptoms & Diagnosis
You can have Zenker’s Diverticulum for years before you notice symptoms. Those symptoms to look for include:
- Trouble swallowing
- Regurgitating food you’ve swallowed
- Bad breath
- Hoarseness
- Persistent cough
- Feeling like there’s something stuck in your throat
- Weight loss
To diagnose Zenker’s Diverticulum, your specialist will order one or more tests, such as:
- Endoscopy (EGD) – allows us to see and evaluate the inside of the upper gastrointestinal system and take biopsies if needed to check for inflammation, infection or damage. We use a small telescopic camera sent through the mouth into the esophagus and stomach.
- Manometry – measures the strength and muscle coordination of your esophagus when you swallow.
- Upper GI X-Ray – with barium and a special X-ray machine, we take images of the esophagus, small intestine and stomach while you swallow
Treatment Options
Our team is skilled in the latest treatment for Zenker’s Diverticulum, including:
- Per Oral Esophageal Myotomy (POEM). In this endoscopic procedure, your specialist will make a small incision in the lining of your esophagus and cut the septum that has formed where the pouch bulges from the esophagus. This approach is effective and less invasive than surgery. In addition, there’s a lower risk that the condition will return.
- Surgery. Your surgeon will remove, move or alter the pouch so it doesn’t trap food. The procedure can be done as an open surgery with incisions in the throat. The approach taken is based on your condition.
Living with the Condition
Even after treatment, Zenker’s Diverticulum can pose a challenge swallowing. To avoid this — and help prevent future issues — we suggest:
- Taking small bites of your food.
- Chewing each bite well.
- Sipping water between bites.
- Avoiding foods with seeds or eating the skin of tomatoes or apples because they are more likely to get stuck in the pouch.