Which symptom is considered classic for Zenker's diverticulum?

The symptom that is considered classic for Zenker's diverticulum is regurgitation of undigested food and liquid several hours after eating. This occurs because Zenker's diverticulum is an esophageal diverticulum that forms at the upper esophagus, leading to the accumulation of food and liquid in the diverticular pouch. When this pouch becomes full or when the normal swallowing process is disturbed, the contents can be regurgitated back into the throat, often undigested, and can occur several hours post-ingestion.

This regurgitation can be particularly distressing for patients, as the esophagus may not effectively clear the retained food, leading to potential choking or aspiration. The timing of the regurgitation—occurring hours after meals—often distinguishes it from other types of esophageal disorders.

In contrast, chest pain, severe heartburn, and difficulty swallowing liquids can be associated with numerous other gastrointestinal conditions and do not specifically characterize Zenker's diverticulum. Therefore, the pronounced regurgitation of undigested food is the hallmark symptom that aligns with the pathophysiology of Zenker's diverticulum.