Print Overview Zenker's diverticulum Enlarge image Close Zenker's diverticulum Zenker's diverticulum In Zenker's diverticulum, a bulge or a pouch forms at the top of the esophagus, as shown in the image on the far right. A typical esophagus is shown on the left. In Zenker's diverticulum, a bulge or pouch forms at the top of the tube that connects the throat to the stomach, called the esophagus. The condition is not common. Connected bands of muscle that work to pass food from the mouth to the stomach make up the esophagus. Over time, the bulge of Zenker's diverticulum can get bigger. Food, pills and even thick mucus can get stuck in the pouch instead of going through the esophagus. This can lead to problems with eating and other complications. The cause of Zenker's diverticulum is not known. It happens most often to men older than 60. Treatment for symptoms of Zenker's diverticulum often is surgery. SymptomsA small Zenker's diverticulum may not have any symptoms. But the bulge may get bigger over time. It can trap food, mucus and pills. Symptoms might include: Trouble swallowing, called dysphagia. Burping. A gurgling noise at the back of the throat. Coughing. Hoarseness. Bad breath. Choking. If the pouch gets big enough, what's in it may spill into the throat. Then Zenker's diverticulum symptoms might include: Feeling of food stuck in the throat. Coughing up or spitting up food 1 to 2 hours after eating. This is called regurgitation. Breathing food into the lungs, called aspirating. Request an appointment CausesThe cause of Zenker's diverticulum isn't known. It's not known why the walls of the esophagus change to form a bulge or pouch in the condition. The cause of Zenker's diverticulum might involve the muscles of the esophagus not working together. Most often, a muscle at the top of the esophagus relaxes to let the food down. If that doesn't happen, food can get trapped in the esophagus. If the muscle in the area where the food gets trapped is weak, the food can cause the esophagus to bulge and form a pouch. Risk factorsRisk factors for Zenker's diverticulum include: Being older than 60. Being male. Having gastroesophageal reflux disease (GERD) or a condition in which part of the stomach bulges into the chest, called a hiatal hernia. Having spinal surgery. ComplicationsComplications can happen if Zenker's diverticulum isn't treated. The bulge of Zenker's diverticulum can get larger if it's not treated. Complications of Zenker's diverticulum can include: Lung infection. Breathing in food, called aspirating, can lead to a lung infection. This is called aspiration pneumonia. Weight loss and not getting enough nutrients, called malnutrition. Trouble swallowing can lead to weight loss and malnutrition. By Mayo Clinic Staff Request an appointment Diagnosis & treatment June 18, 2024 Print Show references Ferri FF. Zenker diverticulum. In: Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed March 22, 2024. AskMayoExpert. Zenker diverticulum and cricopharyngeal dysfunction (adult). Mayo Clinic; 2023. Zenker's diverticulum. ENThealth. https://www.enthealth.org/conditions/zenkers-diverticulum/. Accessed March 22, 2024. Flint PW, et al., eds. Zenker diverticulum. In: Cummings Otolaryngology: Head & Neck Surgery. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed March 22, 2024. Van Delft F. Zenker's diverticulum. https://www.uptodate.com/contents/search. Accessed March 22, 2024. Fair L, et al. Modern approaches to treating Zenker's diverticulum. Current Opinion in Gastroenterology. 2023; doi:10.1097/MOG.0000000000000941. Townsend CM Jr, et al. Esophagus. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed March 28, 2024. Wagh M, et al. How to approach a patient with Zenker's diverticulum. Gastroenterology. 2021; doi:10.1053/j.gastro.2020.11.018. Wallerius KP, et al. Comparing open versus rigid endoscopic and flexible endoscopic techniques for the treatment of Zenker's diverticulum. Otolaryngology – Head and Neck Surgery. 2023; doi:10.1002/ohn.318. Ekbom DC (expert opinion). Mayo Clinic. Accessed April 18, 2024. Related Zenker's diverticulum Zenker's diverticulumSymptoms&causesDiagnosis&treatmentDoctors&departments Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 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