Schatzki Ring

What is a Schatzki ring?

A Schatzki ring is a ring or circle of extra tissue in your lower esophagus. If you have one, your esophagus narrows so it may be hard for you to swallow food (dysphagia). Your esophagus may become so narrow that food can’t pass through it to your stomach. The condition is named for radiologist Richard Schatzki, who discovered it.

Schatzki rings may not cause symptoms. You may learn you have one after a test for an unrelated issue with your esophagus. You may not need treatment unless the condition makes it hard for you to swallow.

What are the symptoms of a Schatzki ring?

Dysphagia is the main symptom. Other symptoms are:

• Food impaction. You may start a meal but not be able to swallow food or liquid because you have food stuck in the Schatzki ring. You may have sharp or burning pain (odynophagia) when you swallow. You may bring up food or vomit when you try to swallow.
• Noncardiac chest pain. This may feel like there’s something stuck in your chest.

Schatzki ring symptoms often happen when you eat dry bread or pieces of unchewed meat. Symptoms develop over time. They can start at any age, but usually begin after age 25.

What causes a Schatzki ring?

It may be a congenital condition, meaning you’re born with it. But researchers think other things may cause Schatzki rings. For example, conditions that send stomach acid into your esophagus may be responsible. Experts think stomach acid or medication may irritate tissue in your lower esophagus. Over time, your body creates extra tissue at the spot where the stomach acid or medication stays in your esophagus. Conditions that may cause a Schatzki ring include:

• Gastroesophageal reflux disease (GERD). GERD is chronic acid reflux in your esophagus. Acid reflux is when acid from your stomach flows backward into your esophagus.
• Hiatal hernia. Some people wonder if hiatal hernias and Schatzki rings are the same thing. They aren’t, but hiatal hernias are associated conditions. Many people with Schatzki rings have hiatal hernias. This condition happens when the top of your stomach pushes up through an opening in your diaphragm into your chest. This can send your stomach contents into your esophagus, causing irritation.

How do healthcare providers diagnose a Schatzki ring?

A healthcare provider will do a physical exam. They’ll ask about your symptoms and if eating certain foods makes your symptoms worse. They may refer you to a gastroenterologist for diagnosis and treatment.

Your gastroenterologist may do an endoscopy to look at the inside of your esophagus. They may do a barium esophagram. This is a fluoroscopic X-ray of your esophagus. This test lets your provider watch what happens when you swallow a barium tablet. They may call this a barium swallow test. The test lets your gastroenterologist estimate the size of the ring.

The wider the ring of tissue, the narrower your esophagus becomes. That makes it more difficult for food to move to your stomach.

How is Schatzki ring treated?

Your gastroenterologist may do an esophagogastroduodenoscopy (EDG) with esophageal dilation. They’ll use an endoscope to guide a balloon or dilator into your esophagus. An endoscope is a long, thin tube with a light and camera. The balloon or dilator expands to stretch the ring of tissue.

Treatment side effects

An EDG with esophageal dilation may cause side effects like:

• Bleeding
• Heartburn
• Sore throat

Very rarely, esophageal dilation may tear a hole in your esophagus. Contact your gastroenterologist right away if you:

• Can’t swallow
• Feel short of breath
• Have chest pain
• Vomit blood

What can I expect if I have a Schatzki ring?

Esophageal dilation typically keeps the Schatzki ring from trapping food in your esophagus. The treatment makes it easier for you to swallow. The ring can come back, so you may need a follow-up procedure.

How do I take care of myself?

A Schatzki ring can make it hard to swallow food, especially dry bread and chunks of unchewed meat. Your gastroenterologist may recommend you focus on soft foods before and after treatment.

When should I see my healthcare provider?

You should contact your gastroenterologist if your symptoms come back. They may do tests to confirm that a Schatzki ring is redeveloping in your esophagus.

Does a Schatzki ring ever go away?

No, it doesn’t go away on its own. Treatment is the only way to make a Schatzki ring go away. Even then, the condition may come back so you need more treatment.