Pharyngeal (Zenker's) Diverticulum

How Is Zenker’s Diverticulum Diagnosed?

The health care provider makes a diagnosis by taking a medical history and ordering a barium swallow. In this test, barium contrast material is swallowed and x-rays are taken to get pictures of the esophagus.

The health care provider may suggest seeing a gastroenterologist (doctor specializing in disorders of the esophagus, stomach, and intestines). The gastroenterologist may want to do a test called endoscopy. In this test, a scope with a lighted end is inserted into the mouth and passed through the esophagus into the stomach. Endoscopy will confirm the diagnosis and can also look for other disorders such as ulcers, abnormal tissue, and cancer in the esophagus.

How Is Zenker’s Diverticulum Treated?

Surgery is the recommended treatment for people with symptoms. For people without symptoms and with a small diverticulum (less than ¼ inch), treatment may be conservative. This means that the health care provider will wait for symptoms to occur before doing surgery.

Surgery helps dysphagia, cough, and aspiration in almost all people.

DOs and DON’Ts in Managing Zenker’s Diverticulum:

• DO realize that Zenker’s diverticulum can sometimes return after surgery (less than 4% of cases).
• DO understand that if treatment is conservative, you should eat soft foods (e.g., mashed potatoes) that can be easily chewed and swallowed.
• DO call your health care provider if you have problems swallowing, develop a fever, or food gets stuck after swallowing.
• DO call your health care provider if you have shortness of breath.
• DO call your health care provider if you need a referral to a gastroenterologist or surgeon.

• DON’T eat seeds, skins, or nuts. These foods can lead to retaining food in the esophagus and maybe aspirating it.
• DON’T forget that drugs cannot get rid of the diverticulum. However, medicines may be prescribed for heartburn, acid indigestion, or pneumonia from aspiration.