November 01, 2020

Zenker's diverticulum

Fixing a problem pouch

It's difficult to swallow, and your breath has gotten bad enough that you — and others — notice it. You take a test at the clinic, and find out you have developed a pouch at the back of your throat. This condition, called Zenker's diverticulum, is rare and more likely to affect older adults. Men over 70 are most at risk. It's traditionally treated by eliminating the pouch with surgery, which can usually be performed with small incisions.

Down the hatch

Zenker's diverticulum is thought to develop when the swallowing reflex becomes uncoordinated primarily due to thickening of certain throat muscles. This thickening is part of various age-related changes. It increases pressure, potentially causing gradual ballooning of tissue at a weak point in the esophagus.

Intermittent difficulty with swallowing may be noticed early in the development of Zenker's diverticulum. Over months or years, the pouch grows, becoming an increasingly larger trap for swallowed food particles, mucus and even pills. As the pouch fills, you may notice:

  • Continued difficulty swallowing
  • Coughing after swallowing
  • Changes in your voice
  • Tasting of foods or drinks hours after eating or drinking
  • Throat irritation
  • A gurgling noise in your throat

When the pouch becomes large enough, it may spill its contents into the throat hours after eating — especially when lying down — causing coughing and spitting up of food. Pouch contents may cause bad breath or be inhaled into the lungs, causing a lung...