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.
ZD is generally diagnosed by means of a barium swallow, which is also called a contrast esophagram. For this test, patients are asked to drink a barium-containing liquid, which coats the inside of the esophagus and makes its shape and contours appear on x-rays.
Other tests your physician may prescribe for you include:
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. With 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.
Most patients are able to leave 1-2 days after the procedure on a liquid or soft diet and return to normal activity within 1-2 weeks.