Diverticulum is a medical term that refers to an abnormal, pouch-like structure. Diverticula can form in nearly all areas of the digestive tract.

“Zenker’s diverticulum is a pouch that forms at the junction of the pharynx and the esophagus. Behind your mouth and nose is where the pharynx is located.”

“The diverticulum is usually found in the hypopharynx. The pharynx joins the esophagus to the stomach. The area known as the Killian’s triangle is where Zenker’s diverticulum usually appears.”

Zenker’s diverticulum is rare, affecting between 0.01 and 0.11 percent of the population. It tends to occur in middle-aged and older adults, especially people in their 70s and 80s. Zenker’s diverticulum is rare among people under 40. It affects men more often than women.

It is also referred to as pharyngoesophageal diverticulum.


“There are several different ways to classify Zenker’s diverticulum.”

Lahey system Brombart and Monges system Morton and Bartley system van Overbeek and Groote system
Stage 1 small, round protrusion thorn-like diverticulum
2–3 millimeter (mm)
longitudinal axis
<2 centimeters (cm) 1 vertebral body
Stage 2 pear-shaped club-like diverticulum
7–8 mm longitudinal axis
2-4 cm 1–3 vertebral bodies
Stage 3 shaped like a gloved finger bag-shaped diverticulum
pointing downward
>1 cm in length
>4 cm >3 vertebral bodies
Stage 4 no stage 4 esophageal compression no stage 4 no stage 4

Difficulty swallowing, also known as dysphagia, is the most common symptom of Zenker’s diverticulum. It appears in an estimated 80 to 90 percent of people with Zenker’s diverticulum.

“Other signs and symptoms of Zenker’s diverticulum include:”

“Over time, symptoms of Zenker’s diverticulum can get worse if left unaddressed.”

Swallowing requires coordination of the muscles in the mouth, pharynx, and esophagus.

The upper esophageal sphincter is a muscle that allows food to pass through when you swallow. The upper esophageal sphincter closes after you swallow.

“The upper esophageal sphincter is related to Zenker’s diverticulum.”

“The pharynx wall is under pressure when the upper esophageal sphincter doesn’t open all the way. The diverticulum is caused by the excess pressure pushing the tissue outward.”

Gastroesophageal reflux disease (GERD) and age-related changes in tissue composition and muscle tone are also thought to play a role in this process.

“If you or someone you care for is experiencing symptoms of Zenker’s diverticulum, talk to your doctor.”

Zenker’s diverticulum is diagnosed using a test called a barium swallow. A barium swallow is a special X-ray that highlights the inside of your mouth, pharynx, and esophagus. A barium swallow fluoroscopy allows your doctor to see how you swallow in motion.

“There are other conditions beside Zenker’s diverticulum. Your doctor may suggest additional tests to rule out other conditions.”

An upper endoscopy is a procedure that involves using a thin, camera-equipped scope to look at the throat and esophagus. Esophageal manometry is a test that measures pressure inside the esophagus.

“Mild cases of Zenker’s diverticulum may not need immediate treatment. Your doctor might suggest a wait and see approach if you have symptoms or a large diverticulum.”

Changing your eating habits can help improve your symptoms. Try eating less food in a single sitting, chewing thoroughly and drinking between bites.

“Moderate to severe Zenker’s diverticulum cases usually require surgery. There are surgical options. Your doctor can help you understand the options.”

Endoscopic procedures

An ethmoic is a procedure in which a surgeon inserts a tube-like instrument into your mouth. The camera and light are in the endoscope. It can be used to make an incision in the wall to separate the diverticulum from the lining of the esophagus.

“Zenker’s diverticulum can be rigid or flexible. General anesthesia is required for a rigid endoscopy. Endoscopies require neck extension.”

This procedure is not recommended for people who have had a previous procedure.

  • A small diversion.
  • A high body mass index.
  • Difficult extending their neck.

“A flexible endoscopy can be performed without general anesthesia. It is the least intrusive option for Zenker’s diverticulum treatment. It is usually an outpatient procedure that has a low risk of problems.”

“Recurrence rates can be high, even though flexible endoscopies can ease symptoms of Zenker’s diverticulum. Multiple flexible endoscopy procedures can be used to address recurring symptoms.”

Open surgery

“Open surgery is the next option when an endoscopy is not possible. General anesthesia is used for Zenker’s diverticulum surgery.”

The surgeon will make a small cut in your neck to perform a diverticulectomy. This involves removing the diverticulum from the wall. The surgeon can perform diverticular inversions. The diverticulum is changed and sewed in place.

Symptoms are unlikely to reappear in the long term, with open surgery having a high success rate. It requires a hospital stay and sometimes a return to the hospital to remove stitches.

You might need to use a feeding tube for a while. Your doctor might suggest a special diet for you.

“If left unaddressed, Zenker’s diverticulum can grow larger, making your symptoms worse. It can be difficult to stay healthy over time because of swallowing difficulties and other symptoms. You might be sick.”

Aspiration is a symptom of Zenker’s diverticulum. It occurs when you inhale food or other matter into the lungs instead of swallowing it into the esophagus. Complications of aspiration include aspiration Pneumonia., an It is an infectious disease that occurs when food, saliva, or other matter get trapped in your lungs.

“Other rare problems of Zenker’s diverticulum include:”

Approximately 10 to 30 percent of people who undergo open surgery for Zenker’s diverticulum experience complications. Possible complications include:

  • Pneumonia.
  • There is a disease called mediastinitis.
  • Nerve damage.
  • Bleeding.
  • The formation of a body of water.
  • It is an infectious disease
  • There is a narrowing of the arteries.

Discuss the risks of open surgery with your doctor.

“Older adults are usually affected by Zenker’s diverticulum. It happens when a pouch of tissue forms near the pharynx.”

“Mild forms of Zenker’s diverticulum may not need treatment. Moderate to severe forms of Zenker’s diverticulum can be treated with surgery.”

The long-term outlook for Zenker is positive. Most people experience an improvement in their symptoms with treatment.

Article resources