Zenker’s Diverticulum usually presents in older people. Patients will complain of difficulty swallowing, food sticking, a gurgling sound and a fullness in the neck. Often, 20 to 30 minutes after attempting to swallow, they’ll cough out the undigested food.
Diagnosis is made by a Barium swallow (esophagram) in which the patient drinks barium as a radiologist takes X-rays. If Zenker’s Diverticulum is present, physicians can see the outline of the sac and maybe even some barium left in the bottom of it after the swallow is complete.
If Zenker’s Diverticulum is affecting the quality of life significantly, it should be treated. The more traditional surgical procedure involves making a cut in the neck and removing the sac completely. The less invasive endoscopic procedure involves cutting the wall between the sac and the esophagus, so that any food that goes into the sac will flow right into the esophagus. This procedure involves less pain and discomfort and a faster recovery, but may involve a slightly higher chance of recurrence.
The prognosis of Zenker’s Diverticulum is excellent. The majority of patients become free of any swallowing difficulty. There is a small percentage of patients - maybe 20% - who feel a little bit of swallowing difficulty that does not affect their well being, and then there is a percentage of patients - approximately 3% to 7% - that will have a recurrence of symptoms and their diverticulum. These patients will likely need to be retreated.