Important Announcements

Nondiscrimination Policy Update

Boston Medical Center Health System complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, color, national origin (including limited English proficiency and primary language), religion, culture, physical or mental disabilities, socioeconomic status, sex, sexual orientation and gender identity and/or expression. BMCHS provides free aids and services to people with disabilities and free language services to people whose primary language is not English.

To read our full Nondiscrimination Statement, click here.

Zenker's Diverticulum

Select your language:

What is Zenker's Diverticulum?

Zenker's diverticulum (ZD) is a condition characterized by a pouch that develops in the upper esophagus in the neck. The pouch can contain food which can cause difficulty or pain with swallowing and bad breath. Cases of ZD are generally categorized as small, intermediate, or large, depending on the size of the pouch. The condition appears more often in men and women older than 50, and affects men more frequently than women.

Treatment of Zenker’s Diverticulum requires an interdisciplinary approach that draws on various medical specialties. At BMC, physicians in our Center for Minimally Invasive Esophageal Therapies provide comprehensive, quality care including medical oncology, radiation oncology, thoracic surgery, gastroenterology, pathology, pulmonary medicine and radiology.

What are the Symptoms of Zenker's Diverticulum?

Symptoms may include:

  • Discomfort with swallowing
  • Regurgitation of undigested food hours after eating
  • Coughing or the feeling of food sticking in the throat after eating
  • Aspirating food or liquid that enters the airway and causes choking or bleeding
  • Bad breath
  • Unexplained weight loss

What are the Causes?

The cause is most commonly secondary to increased tension in the muscle at the top of the esophagus (called the cricopharyngeus muscle) causing a functional obstruction.

How is Zenker's Diverticulum Treated?

There are currently no medications to treat ZD. Surgery is the main therapeutic approach; however, some small diverticula do not require treatment. Open and endovascular or transoral repair have both been found to be successful.

For open surgery, an incision is made in your neck and the pouch is removed or tacked upside down so it cannot fill—or it is removed completely. An important part of the operation is to cut the muscle just below the diverticulum to prevent recurrence. Most patients must stay in the hospital for one or two days after the procedure.

In endoscopic repair or transoral repair, a stapling device is inserted through the mouth using metal tubes. The muscle between the pouch and the esophagus is divided, thereby making the pouch part of the upper esophagus. This method does not require an incision, is faster, equally effective and reduces the risk of complications, as well as time in the hospital.

Your physician will work with you to determine the best treatment option, according to your unique situation.