Zenker’s Diverticulum
Zenker’s diverticulum is a pouch that forms in the upper throat at the junction between the pharynx and the esophagus. It develops when pressure pushes the inner lining of the throat outward through a weak spot in the muscle wall. Many people experience swallowing difficulties, throat discomfort, chronic cough, or regurgitation of food, while others have no symptoms and discover it incidentally on imaging.
What is it?
Zenker’s diverticulum develops when a weak area in the muscle wall of the throat allows a pouch to form. This weak spot, known as Killian’s dehiscence, sits at the junction between the lower throat (hypopharynx) and the upper esophagus. Food or liquids may collect in the pouch, causing swallowing difficulties or regurgitation. The condition tends to progress slowly over years.
Imaging, especially a barium swallow, can clearly show the pouch and how it fills during swallowing. CT scans may be used to assess surrounding structures or rule out other abnormalities. Endoscopy provides a direct view and helps plan treatment if symptoms are significant.
Important to Know
Symptoms may be mild at first but can become more noticeable as the pouch enlarges. People may cough frequently, clear their throat often, or notice undigested food returning to their mouth hours after eating. In some cases, Zenker’s diverticulum can contribute to aspiration—when food or liquids enter the airway—which may cause coughing or lung infections.
Red flag symptoms include repeated aspiration, pneumonia, unintentional weight loss, or difficulty swallowing that worsens over time. Treatment depends on the size of the diverticulum and severity of symptoms. Many people benefit from minimally invasive endoscopic procedures that divide the tissue between the pouch and esophagus, improving swallowing.