A Schatzki ring is a narrowing of the lower part of the esophagus that can cause chest pain or difficulty swallowing. It is often caused by long-term damage from acid reflux or GERD. Diagnosis is done through barium X-rays or endoscopy, and treatment involves fracturing or stretching the ring with an endoscope, dilator, or balloon. Surgery is rarely necessary.
A Schatzki ring, also known as a Schatzki-Gary ring, is a narrowing of the lower part of the esophagus, a muscular tube through which food passes to the stomach. Schatzki’s ring is named after Robert Schatzki, the radiologist who first characterized it. The cause of Schatzki’s rings has not been determined with certainty. Some doctors, however, believe it is caused by long-term damage from stomach acid reflux or gastroesophageal reflux disease (GERD), a condition in which fluid from the stomach rises up into the esophagus, inflaming and damaging its lining. Treatment for a Schatzki ring includes fracturing it with an endoscope, enlarging it with a dilator, or expanding it with a special balloon.
Usually, a Schatzki ring doesn’t cause any symptoms. Mindfulness, however, is usually triggered by poorly chewed food that gets stuck in the esophagus, as the patient would consequently have chest pain or difficulty swallowing, known as dysphagia. This may force the patient to stick a finger into the back of the throat to regurgitate the food, i.e. to force it out of the mouth.
Typically, a Schatzki ring is diagnosed by a doctor who does a barium X-ray examination or an endoscopy. A barium x-ray is a medical imaging procedure used to examine the gastrointestinal tract, which includes the esophagus and stomach. Because these tests can occasionally miss the rings, an esophagogastroduodenoscopy (EGD), or endoscopy, is a better diagnostic method. Endoscopy visualizes the gastrointestinal tract from the esophagus, which connects to one end of the stomach, to the duodenum, the upper section of the small intestine that connects to the other end of the stomach.
Unlike the barium x-ray test, endoscopy is an invasive procedure that involves inserting an endoscope, an instrument used to examine the inside of a body organ, through the patient’s mouth into the esophagus. This is especially helpful for patients who can neither regurgitate nor swallow food, so the obstruction can be stopped as soon as possible to prevent further chest pain and other complications. During this diagnosis, your doctor may use the endoscope to check for other medical conditions, such as cancer and esophagitis.
Treatment of a Schatzki ring involves stretching or fracturing it with the endoscope, thus allowing food to move freely. The use of an endoscope, however, is not the only treatment tool used. Tapered dilators can be used to widen the esophageal passage. Similarly, deflated balloons can be placed through the Schatzki ring and then inflated to make it wider. In the most extreme cases, open surgery may be applied, although such an event is extremely rare.
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