Medical Edge Newspaper Column

Zenker's Diverticulum Can Be Corrected With Surgery

May 2, 2008
Dear Mayo Clinic:
I have a Zenker's diverticulum. It makes it hard to swallow food and makes me cough at night. At 83, can I have surgery for this?

Answer:
If you're reasonably healthy, you probably can. Procedures to treat Zenker's diverticulum are very effective and have low complication rates.

Zenker's diverticulum, also called a pharyngeal diverticulum, is a pouch in the wall of the lower throat, usually occurring in adults over 50.

This pouch is caused by a muscle in the upper esophagus that won't relax. With every swallow, bits of food and even pills can become trapped in the pouch. As the pouch fills, you may notice throat irritation, bad breath or a gurgling noise. When the pouch becomes large, it may also spill food into the throat hours after eating, causing coughing and spitting up of food — especially when you're lying down.

When Zenker's diverticulum becomes troublesome, surgery to cut the muscle that won't relax — with or without removal of the pouch — is often recommended.

These procedures can often be performed using a less invasive technique that involves operating with a flexible endoscope through the mouth. Many people who have this done are out of the hospital in less than one day.

However, the studies of flexible endoscopic procedures are somewhat limited and the complication rate remains less well studied.

— Todd Baron Sr., M.D., Gastroenterology, Mayo Clinic, Rochester, Minn.