Download and print as PDFDownload
Many years ago, Schatzki described a smooth, benign, circumferential, and narrow ring of tissue in the lower end of the oesophagus (the food pipe that connects the mouth to the stomach). These rings are located just above the junction between the oesophagus and the stomach. These rings are very common occurring in more than 6% of the population. The cause of these rings is not clearly understood, while some doctors believe they are caused by long term damage from stomach acid reflux.
The majority of these rings cause no symptoms, and patients are unaware of their presence. When the opening of the oesophagus becomes smaller as the diameter of these rings shrink, solid, poorly chewed food (such as steak, turkey, frankfurter) can get caught at the level of the ring. The patient then experiences chest pain, or sticking sensation in the chest with swallowing (referred to as dysphagia). If the food bolus does not pass into the stomach, some patients have to regurgitate the obstructed bolus of food before they can resume eating. Rarely, the bolus becomes impacted (the food bolus cannot pass nor can it be regurgitated). These patients experience continued chest pain and difficulty handling saliva and secretions. A flexible endoscope has to be inserted through the mouth into the oesophagus to extract the impacted food to relieve obstruction.
The diagnosis of Schatzki ring can usually be made by barium x-ray examination of the oesophagus. In patients with symptoms of dysphagia, doctors usually also order an upper endoscope examination. During this examination, a flexible viewing tube is inserted through the mouth into the oesophagus. It allows for direct visualisation of the lining of the oesophagus and the stomach.
Management of these rings involve procedures that will stretch or fracture these rings, thus allowing freer passage of solid food. Stretching or fracturing can be performed with endoscopes, or tapered dilators inserted through the mouth, or dilator balloons placed across the ring by endoscopes. Open surgery is hardly ever necessary to handle these rings.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: February 2020
Review Date: December 2022