Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Schatzki ring?
This is a medical condition where you have a narrowing of the lower part of your esophagus. Your esophagus is the muscular tube in which food passes to your stomach. It is also known as Schatzki-Gary ring. This medical condition is named after the German-American physician/radiologist Robert Schatzki, who first characterized it in 1953. This is a specific esophageal ring with Schatzki rings being divided into subcategories.
- A rings – these are the rings that are above your esophagus/stomach junction
- B rings – these are the rings that are in your lower esophagus at the squamocolumnar junction.
Symptoms of Schatzki ring
Usually a person with Schatzki ring will not have any symptoms because most people are not aware of them being there. When the opening of your esophagus becomes smaller because of the shrinkage of the diameter of the rings, this is when a person might notice it. They usually first notice it when the diameter of the ring gets approximately one centimeter and chunks of food feel like they are stuck in the throat. If there are any symptoms at this point they would be:
- Chest pain
- Having difficulty swallowing, which is called dysphagia
When the food such as turkey, hotdogs, steak, or other poorly chewed solid chunks passes into your stomach the symptoms will usually go away.
Schatzki ring Causes
The exact cause has not been firmly determined but there are some physicians who feel that Schatzki rings are caused by the long term damage that is the result from having gastroesophageal reflux disease (GERD) or stomach acid reflux. GERD is the medical condition in which the person’s stomach liquids shoot up into their esophagus. When this happens the lining of your esophagus becomes damaged and inflamed. When the damage is healed it forms a scar which is the Schatzki ring.
It is typically diagnosed in one of two ways.
The physician will use an endoscopy, which is a minimally invasive procedure that will allow your physician to evaluate and identify the function of your esophagus and see if there is a Schatzki ring. The physician will use an endoscope, a medical instrument that uses fiber optic technology to see your esophagus using a small thin tube that is equipped with a tiny camera and a light source.
The physician can do a barium x-ray examination, which is an imaging procedure they will use to examine your gastrointestinal tract. This includes your stomach and esophagus. This is not an invasive procedure. This is most likely the first test the physician will use.
Occasionally the barium x-ray examination will miss the Schatzki ring so your physician may need to do either an endoscopy or an esophagogastroduodenoscopy (EGD). Both of these are better methods of diagnosing Schatzki ring. Doing an endoscopy is helpful for a patient who can neither swallow nor regurgitate food so they can find the obstruction and get rid of it as soon as possible. When the physician does the endoscopy they will usually check to see if there are any other medical conditions such as esophagitis, which is the inflammation or swelling of your esophagus or cancer.
Schatzki ring Treatment
If a person has difficulty in swallowing chunks of food they can try to force themselves to regurgitate the food if they cannot swallow it. They would have to stick a finger in the back of their throat in order to get themselves to throw up so the stuck food comes out of their mouth. If they cannot swallow or regurgitate the food they need to seek immediate medical help. If a person notices that they are having trouble swallowing chunks of food and it has been diagnosed that they have Schatzki ring it can be treated in several different ways.
- Enlargement with a tapered dilator which is usually done using intravenous sedation to help decrease the discomfort of the procedure.
- Fracturing or stretching the Schatzki ring with an endoscope to permit the food to move freely to your stomach.
- Expansion with a special balloon. They will put a deflated balloon across your Schatzki ring and then the balloon will be inflated to widen it.
In extremely rare cases a person may have to have surgery to widen the Schatzki ring. If the Schatzki ring is asymptomatic, which means they are causing no symptoms, do not usually worsen over time so they will need no treatment. When a person has dilation procedure done it can last for months to years. The dilation procedures can be repeated if it happens again.
Schatzki ring Pictures