About schatzki ring (schatzki's ring)

What is schatzki ring (schatzki's ring)?

A Schatzki ring is a narrowing of the lower esophagus that can cause dysphagia. Dysphagia means difficulty in swallowing. Dysphagia itself is rather common and occurs in about 3 percent of the population.

The Schatzki ring is comprised of a small tissue fold that partially blocks the esophagus, leading to the dysphagia. The Schatzki ring was first identified in asymptomatic people in 1944. It’s named for Richard Schatzki, the doctor who first made the observation.

The presence of a Schatzki ring is a leading cause of dysphagia of solid foods as well as blockage of the esophagus by food (impaction) in adults.

What are the symptoms for schatzki ring (schatzki's ring)?

Steakhouse syndrome symptom was found in the schatzki ring (schatzki's ring) condition

Many people who have a Schatzki ring often don’t experience any symptoms. Those who do periodically feel Difficulty swallowing solid foods. In some cases, you may feel as if food is sticking in your chest after swallowing. Many times, the food can be regurgitated.

Sometimes a portion of food can get stuck within the esophagus, causing a blockage and severe Chest pain. This sensation commonly occurs with meat that hasn’t been chewed completely. It’s sometimes referred to as “steakhouse syndrome.”

Additionally, individuals with Schatzki rings often experience Heartburn.

What are the causes for schatzki ring (schatzki's ring)?

A Schatzki ring has been found to be present in 6 to 14 percent of routine barium swallowing studies. Symptoms are caused because of the narrow portion of the esophagus that makes up the Schatzki ring. The diameter of the Schatzki ring is very important as far as symptoms are concerned. Rings of a smaller diameter typically cause more frequent episodes of dysphagia than rings of a larger diameter.

Doctors aren’t sure what exactly causes a Schatzki ring to form. Gastroesophageal reflux disease, also known as GERD, is a possible cause of Schatzki ring formation. People with a Schatzki ring often have acid reflux disease as well. Additionally, conditions that can lead to reflux disease, such as a hiatal hernia, are often found in people with a Schatzki ring.

What are the treatments for schatzki ring (schatzki's ring)?

Therapy provided to individuals with a Schatzki ring includes balloon dilation of their esophagus. This is a procedure that uses an instrument with a small balloon on the end to manually increase the diameter of the Schatzki ring. Typically, a decrease in symptoms is reported shortly after the dilation procedure.

Based on the association between the presence of a Schatzki ring and GERD, acid suppression therapy alone or with balloon dilation has also been shown to be effective in relieving symptoms.

What are the risk factors for schatzki ring (schatzki's ring)?

Schatzki ring is a product of the body's response mechanism to repeated exposure to acid that occurs during gastroesophageal acid reflux and a way to prevent the development of Barret's esophagus. It appears as a thin membranous structure, containing an upper layer comprising squamous epithelial cells and a lower layer comprising columnar epithelial cells.

Schatzki ring is always associated with dyspnoea and eosinophilic esophagitis. The ring does not cause symptoms until it expands to a diameter that obstructs the food movement. After reaching this stage, patients may develop odynophagia or chest pains.

Risk factors

  • Dietary factors: Some of the ways of eating also offer risks of developing the disease: Swallowing practices like faster without chewing well, ingesting a large number of food bites at a time, spicy and rough foods like meat and harsh vegetables. Consumption of foods that trigger acidity, such as chocolate.
  • Gastroesophageal acid reflux: Acid reflux is the reverse movement of gastric and bile content towards the esophagus. The following are the causes: medications that trigger acidity, for example, aspirin, dinner at late night and large meals, beverages like alcohol and coffee, and fatty and fried foods.

Steakhouse syndrome,Dysphagia,Barret's esophagus,Hiatal hernia
Difficulty during swallowing,Bolus obstruction,Chest pain,Heartburn

Is there a cure/medications for schatzki ring (schatzki's ring)?

Schatzki ring is a circular membrane of the mucosal and submucosal layer of the distal esophagus at the squamocolumnar junction. It grows over time in diameter and causes bolus obstruction that leads to pain during swallowing.
There are three types:

  • A-rings: The ring forms above the junction between the stomach and esophagus.
  • B-rings: The ring forms between the lower end of the esophagus and the junction between the esophagus and stomach. This is the most common type.
  • C-rings: The rings develop below the junction. This is the least type of Schatzki ring.

Treatment is not necessary for the patients until the symptoms do not appear. The treatments include:

  • Widening of Schatzki ring using a blunt-tipped instrument called bougie, guided by visual aid of endoscopy. Bougies can be used with or without a guidewire. Fluoroscopy can also be used to visualize dilation and direct the procedure.
  • Balloon dilation is a procedure in which a balloon is inserted and inflated at the position of Schatzki ring.
  • Acid suppression therapy to minimize acid reflux: quitting smoking, dinner intake at least three hours before bedtime, avoiding spicy foods, caffeine, and chocolate.
  • Dietary practices: The patients can take measures of thorough chewing of food before swallowing or sipping water in between the bites. Thorough chewing lubricates the food for its movement down the food pipe. The measures comfort the swallowing.

Steakhouse syndrome,Dysphagia,Barret's esophagus,Hiatal hernia
Difficulty during swallowing,Bolus obstruction,Chest pain,Heartburn

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