A diverticulum is a sac or pocket that forms on a portion of the body. A Zenker’s diverticulum is a pouch that develops on the pharynx, in the upper part of the swallowing passage. It may trap food, causing difficulty or pain when swallowing. Other side effects include bad breath, regurgitation, coughing, unexplained weight loss, irritation of the throat and aspiration (the passage of food or liquid into the lungs). Zenker’s diverticulum is the most common type of esophageal diverticulum.
What Causes Zenker’s Diverticulum?
The most common cause of Zenker’s diverticulum is increased muscle pressure in the upper esophagus or pharynx. This extra pressure causes a pouch to form in the muscle. It may be attributed to loss of elasticity or atrophy of the muscle, abnormal timing of the muscle while swallowing, a central nervous system disorder, gastroesophageal reflux disease (GERD) or an abnormality in the upper esophageal sphincter.
Zenker’s diverticulum is more common in men than women, and largely confined to older adults over the age of 50.
Diagnosing and Treating Zenker’s Diverticulum
To diagnose Zenker’s diverticulum, patients are usually given a videofluoroscopic evaluation of swallowing. This is an X-ray study that is performed by both a radiologist and a speech and language pathologist (SLP). The SLP will give you different foods and drinks mixed with barium, which is a contrast material that allows what you’ve swallowed to show up on the x-ray. X-ray images are recorded only while you swallow in order to limit your exposure to radiation. This study helps determine the size and location of the pouch.
Treatment depends on the size of the pouch and may consist of:
- Swallowing therapy
- Reflux medications
- Endoscopic surgery (performed through the natural opening of the mouth and throat)
- Open surgery (performed through an incision in your neck)
The first step is to have an evaluation by a qualified ENT or laryngologist (swallowing subspecialist) to ensure accurate diagnosis and efficient treatment. If you are having concerns with your swallowing, call DeFatta ENT & Allergy at (715) 828-2368 for more information or to schedule an appointment.