What is Schatzki (Schatzki's) ring? What causes it?
Schatzki (Schatzki's) ring is described a smooth, benign (non-cancerous), circumferential, and narrow ring of tissue in the lower end of the esophagus (the food pipe that connects the mouth to the stomach). Schatzki rings are common and are located just above the junction of the esophagus with the stomach. The cause of Schatzki rings is not clearly understood. Some doctors believe they are caused by long-term damage from reflux of stomach acid (gastroesophageal reflux disease, GERD).
What are Schatzki ring symptoms and signs?
The majority of these rings cause no symptoms, and people do not know they are there. As the diameter of these rings shrink; solid, poorly chewed food, for example, steak, turkey, or hotdogs, that stays in chunks can get caught at the level of the ring. This occurs when the diameter of the ring reaches approximately 1 cm (0.4 inches). The person with Schatzki ring then experiences chest pain, or sticking sensation in the chest with swallowing (referred to as dysphagia). When the chunk of food passes into the stomach, symptoms subside quickly and the person can resume eating. If the food does not pass into the stomach, some people have to induce regurgitation of the food by sticking their finger in the back of their throat before they can begin eating.
Rarely, food becomes impacted (the food cannot pass nor can it be regurgitated). Symptoms of impacted food in the throat include chest pain, difficulty swallowing, decreased saliva and secretion production. A flexible endoscope has to be inserted through the mouth into the esophagus to extract the impacted food to relieve the obstruction.
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Acid reflux or GERD is thought to be a cause of Schatzki rings in the esophagus. Certain beverages and foods should be avoided because they cause acid reflux or GERD. For example, drinks with alcohol or caffeine and foods like raw onions, black pepper, spicy foods, garlic, tomatoes, and citrus fruits and juices.
How is Schatzki ring diagnosed?
The diagnosis of Schatzki ring can usually be made by barium X- ray examination of the esophagus; however, a narrow ring can be missed on X-ray. In patients with symptoms of dysphagia, doctors usually also order an upper intestinal endoscopy examination. Endoscopy is the best way of diagnosing a Schatzki ring. During the endoscopy, a flexible viewing tube is inserted through the mouth into the esophagus. It allows a direct view of the inner lining of the esophagus and the stomach. The test helps to exclude early cancer, esophagitis, and Barrett's esophagus that also may cause narrowing of the esophagus.
What treatment is for Schatzki rings? Can they be cured?
There is no cure for Schatzki rings. Treatment and management of the condition includes procedures that will stretch or fracture the rings, which will allow solid food to pass through the esophagus more freely. Schatzki rings can be stretched or fractured with endoscopes or tapered dilators inserted through the mouth. They also can place deflated balloons across the ring and then inflate them. Occasionally, Schatzki rings may be cut with an electrocautery probe. Rarely, surgery is necessary to treat Schatzki rings.
Medically Reviewed on 3/20/2018
Guelrud, Moises, M.D. "Management of benign esophageal strictures." UptoDate.com. Updated Feb. 8, 2016.