Schatzki Ring

What Is a Schatzki Ring?

A Schatzki Ring (esophagogastric ring or 'B' ring) is a condition involving the mucous membrane of the lower esophagus in which there is an abnormal ring of tissue inside the lower part of the esophagus. This fibrous scar tissue causes narrowing and partial blockage of the esophagus.

 

Most gastroenterologists believe that these rings can form as a result of chronic gastroesophageal reflux (GERD). Patients may not have the usual symptoms of GERD, but the unnoticed chronic reflux can cause inflammation of the lower esophagus and eventually lead to the formation of fibrous scar tissue. Most people with this lower esophageal Schatzki ring have no symptoms.

 

Diagnosis

A Schatzki ring is usually found during diagnostic procedures (upper endoscopy, GI barium series) for unrelated GI problems. In patients that present with symptoms, an upper endoscopy is usually ordered to diagnose the problem and exclude other disease such as Barrett's esophagus.

 

Symptoms

The most common symptom is intermittent dysphagia. When this occurs, it is usually solid food that causes the problem. In some cases, food actually gets blocked (steakhouse syndrome) from entering the stomach. These patients end up in the emergency room, where an endoscopy is done. The blocked food is dislodged and the diagnosis is confirmed.

 

Treatment

Schatzki ring is generally treated with dilation of the ring. The dilation breaks the ring which resolves the dysphagia. This procedure is done endoscopically, using a tapered dilator or dilator balloon. Surgery is very rarely necessary to treat these rings.

 

Prevention

Since the cause of Schatzki rings is not known for sure, there are no definitive preventive measures. However, patients who also suffer from GERD should be treated with medications (H2 blockers, Proton pump Inhibitors) to stop the reflux from possibly contributing to the Schatzki ring problem.

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