Difficulty swallowing is a common complaint. When food sticks in the lower throat, coughing or choking occurs with meals, and there are symptoms of regurgitation of food matter after meals, the diagnosis of a pharyngeal or esophageal diverticulum should be considered. If you experience these symptoms, you should seek the care of an otolaryngologist or a gastroenterologist, and a barium esophagram should be obtained. This consists of swallowing contrast material, which outlines the contour of the swallowing tube.
The most common type of pharyngeal diverticulum is the Zenker's diverticulum, which occurs in the lower throat starting just above the upper esophageal sphincter. A less common type is the Killian-Jamieson diverticulum, taking off just below the upper esophageal sphincter. These are less commonly symptomatic, but can also present with the same symptoms as a Zenker's diverticulum.
Treatment consists of surgery if the pouch is symptomatic. Minimally invasive surgery is preferred, including endoscopic procedures. In some cases (smaller pouches, restricted mouth opening or neck extension) surgery through the neck is preferable.
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