Lower esophageal ring

Definition

A lower esophageal ring is an abnormal ring of tissue that forms where the esophagus (the tube from the mouth to the stomach) and stomach meet.

Alternative Names

Esophagogastric ring; Schatzki's ring

Causes, incidence, and risk factors

A lower esophageal ring is a matter of debate can be caused from swallowing dangerous acids or other corrosive materials. In some cases, it is a birth defect. Sometimes, it is due to injury caused by gastroesophageal reflux disease (GERD).

Symptoms

• Chest pain under the breastbone
• Difficulty swallowing

Signs and tests

Tests that show the lower esophageal ring include:

• EGD (esophagogastroduodenoscopy)
• Upper GI (x-ray with barium)

Treatment

Treatment involves stretching the ring by passing a device called a dilator through the area. Sometimes, a balloon is placed in the area and inflated, which helps widen the abnormal ring.

When dilation does not work, surgery may be need to cut away the abnormal tissue.

Any reflux issues, such as GERD, should be treated.

Expectations (prognosis)

Swallowing problems may return. Repeated treatments may be needed.

Calling your health care provider

Call for an appointment with your health care provider if you have swallowing problems or symptoms of GERD.

References

Maish M. Esophagus.In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2008:chap.41.