“…Other studies have suggested an association with lower esophageal sphincter dysfunction and gastroesophageal reflux with subsequent hypertonic upper esophageal sphincter muscles leading to a pulsion diverticulum. 1,2 The prevalence of ZD in the general population is between 0.01% and 0.11%, and it usually manifests between the seventh and eighth decades of life. Common symptoms include dysphagia, weight loss, regurgitation, halitosis, and chronic cough with recurrent pneumonia.…”