A Zenker’s diverticulum is a pouch that forms at the entrance to the esophagus (the swallowing tube). In some patients, during swallowingthere is excessive pressure against the back wall of the throat caused by excess contraction of the sphincter muscle at the entrance to the esophagus. Over a lifetime of swallowing, this causes the weakest portion of the pharyngeal wall to balloon out. Over time, as the balloon grows, a false passageway called a diverticulum forms which can gradually increase in size and become several centimeters in diameter. Thus, this is a condition almost always seen in the elderly (patients over 60).
The most common symptoms of a Zenker’s diverticulum are:
When the Zenker’s diverticulum is small, most patients usually experience no symptoms, but as it increases in size, over time, the symptoms listed above begin to develop. Food may be regurgitated back into the throat or mouth in a relatively undigested form, several minutes to hours after eating. Patients may even feel or see a large lump in their neck, typically on their left side, that increases in size after eating.
The diagnosis of a Zenker’s diverticulum is made using a simple radiographic test called a barium swallow. A contrast material called barium is swallowed and the diverticulum is able to be visualized using a real-time x-ray called fluoroscopy.
Surgical intervention is the only treatment available that will effectively cure patients with a Zenker’s diverticulum, permanently relieving symptoms and improving the quality of life. There are no medications available that will treat the condition and if left untreated, patients with a Zenker’s diverticulum will continue to have difficulty swallowing, with possible associated risks of weight loss, malnutrition, and pneumonia caused by food entering the lungs from the pouch. Although uncommon, these can be life-threatening.
The physicians at CornerStone Ear, Nose & Throat are experts at diagnosing and treating swallowing problems. We can perform an endoscopic excision of a Zenker’s diverticulum which is an approach done through the mouth to correct the Zenker’s diverticulum. This newer technique is less invasive than the traditional approach of removing a Zenker’s diverticulum through an incision in the neck. This allows for a quicker recovery and return to a normal diet in a shorter period of time. Although technically difficult, this procedure is a safer approach for the patient when it can be performed successfully.
Patients experiencing prolonged difficult or painful swallowing should consult one of the board-certified otolaryngologists at CornerStone Ear, Nose and Throat, PA. While these symptoms could indicate a Zenker’s diverticulum, there are a variety of other conditions that could be the cause. The physicians at CornerStone Ear, Nose & Throat, PA, will gladly help you understand and resolve your swallowing difficulties.