Ear, Nose and Throat

What to know about a Schatzki ring

A Schatzki ring is a circular band of mucosal tissue that can form at the end of the food pipe closest to the stomach. The ring of tissue causes the food pipe, or esophagus, to narrow.

When a ring forms, a person may have no symptoms. Or, they may have difficulty swallowing, which the medical community calls dysphagia. The difficulty may get worse when a person eats dry bread or meat.

Schatzki rings are not cancerous, and they are usually harmless. Changing the diet and patterns of eating can help with symptoms.

In this article, we explore the symptoms and causes of a Schatzki ring. We also describe how a doctor makes a diagnosis and the treatment options.

Signs and symptoms

woman with difficulty swallowing that may have Schatzki rings
Symptoms of Schatzki rings may include difficulty swallowing solid food and a sensation of food being caught in the throat.

Many people with Schatzki rings experience no symptoms. Others usually start to notice symptoms after the age of 25.

Upon examination, a doctor may find that the diameter of the esophagus, which is normally around three-fourths of an inch, is reduced to half an inch.

Those with symptoms may notice the following:

  • difficulty swallowing solid foods
  • dysphagia that comes and goes
  • a sensation of food being caught in the throat or chest
  • heartburn

Symptoms are usually more severe when the ring is large and resulting in more pronounced narrowing of the food pipe.

Sipping water between bites and chewing food thoroughly can make swallowing easier.

One possible complication of a Schatzki ring is food bolus obstruction, or “steakhouse syndrome.” This involves a ball of food completely blocking the esophagus, often because it has not been thoroughly chewed.

A food bolus obstruction can cause severe chest pain, and it is considered a medical emergency. Treatment involves a doctor pushing or pulling away the ball of food using an endoscope, which is a long, flexible tube.


Causes

Doctors are not sure why some people develop a Schatzki ring.

The condition can run in families. In others, a Schatzki ring forms in response to irritation caused by acid reflux or gastroesophageal reflux disease (GERD).

Diagnosis

A doctor will first ask about a person’s symptoms and perform a physical examination. The following tests can help the doctor to confirm the presence of a Schatzki ring:

  • An X-ray with a barium swallow. This involves a person swallowing a pill containing barium contrast dye, which coats the lining of the esophagus, making the X-ray image clearer. Around 6–14 percent of these tests show evidence of a Schatzki ring.
  • Endoscopy. In this procedure, a doctor inserts a narrow tube containing a camera into the esophagus. The camera sends images that help a doctor to see whether there is an obstruction, such as a Schatzki ring.


Treatment and recovery

woman shows a broken cigarette
Quitting smoking can help to reduce acid reflux.

Treatment is not always necessary if a person experiences no symptoms. Many people avoid symptoms by chewing food thoroughly and taking sips of water between bites.

If a person tries these techniques but still has trouble swallowing, certain procedures can widen the diameter of the food pipe, making it easier to swallow.

Possible treatments include:

  • Inserting an endoscope into the esophagus and using a blunt-tipped instrument called a bougie to widen the Schatzki ring.
  • Inserting a tiny balloon into the esophagus and inflating it to widen the ring, in a process called balloon dilation. People with difficulty swallowing often find relief soon after undergoing this procedure.
  • Because many people with Schatzki rings also experience symptoms of GERD, acid suppression therapy can help.
  • In rare cases, a doctor will recommend surgically widening the food pipe.

A person can try to reduce acid reflux by:

  • avoiding trigger foods, such as caffeine, coffee, and chocolate
  • avoiding spicy and particularly fatty foods
  • quitting smoking
  • reducing stress
  • losing weight if overweight
  • changing medications that may be causing symptoms

Outlook

A Schatzki ring is a band of tissue that can form in the lower esophagus, causing the pipe to narrow. While some people with Schatzki rings have no symptoms, others experience difficulty swallowing. A person may also find that food becomes stuck in their throat.

A doctor will be able to determine whether someone has a Schatzki ring. They may recommend a procedure to widen the ring’s diameter.

Lifestyle changes and acid suppression therapy can also help to relieve symptoms of a Schatzki ring.

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