Lower esophageal ring

Schatzki ring - X-ray

A solution containing a dye (barium), which is visible on X-rays, has been swallowed (upper GI series) and X-rays have been taken of the esophagus. There is a narrowing near the stomach (indicated by the arrow). This non-cancerous ring of tissue (Shatzki’s ring) may cause swallowing problems (dysphagia) and can be treated with dilation of the stricture.

Also known as: Esophagogastric ring and Schatzki's ring

Definition

A lower esophageal ring is an abnormal ring of tissue that forms where the esophagus (the tube from the mouth to the stomach) and stomach meet.

Causes, incidence, and risk factors

A lower esophageal ring is a birth defect of the esophagus that occurs in 4% of people. It causes narrowing of the lower esophagus.

Narrowing of the esophagus may also be caused by:

Symptoms

For most people, lower esophageal ring does not cause symptoms.

The most common symptom is a sensation that food, especially solids, is stuck in the lower neck or under the breastbone (sternum) when it is swallowed.

Signs and tests

Tests that show the lower esophageal ring include:

Treatment

Treatment involves stretching the ring by passing a device called a dilator through the area. Sometimes, a balloon is placed in the area and inflated, which helps widen the abnormal ring.

Expectations (prognosis)

Swallowing problems may return. Repeated treatments may be needed.

Calling your health care provider

Call for an appointment with your health care provider if you have swallowing problems.

References

Long JD, Orlando RC. Anatomy, histology, embryology, and developmental anomalies of the esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010: chap 41.

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Review date:
November 11, 2010
Reviewed by:
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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