Esophageal webs or rings are thin, membranous folds of tissue that form in the esophagus. Health professionals may use both “webs” and “rings” to refer to the same structure. These structures make the esophagus narrower, blocking it fully or partially.
The esophagus is a tube that joins the mouth and throat to the stomach. Webs or rings can form anywhere in the esophagus, but they’re more common in the upper part of the esophagus that’s closest to the throat.
Esophageal webs can make it more difficult to swallow food. In other cases, they don’t cause any noticeable symptoms.
It isn’t clear exactly what causes esophageal webs. Though rare, they’re more likely to occur in people who have certain conditions, such as iron deficiency anemia.
Keep reading to find out more about the symptoms, causes, and treatments for esophageal webs.
Picture of esophageal web
What are the symptoms?
The most common sign of an esophageal web is difficulty swallowing solid foods. This is called dysphagia. Dysphagia is a symptom of a number of other conditions. Experiencing dysphagia doesn’t necessarily mean you have an esophageal web.
Esophageal webs can make you feel like you’re about to choke when you swallow food. In other cases, they make it difficult to swallow other substances, such as pills or liquids.
Swallowed foods such as meats or breads might get caught in the web, creating the sensation that you have something stuck in your chest. You might cough to try to dislodge the food.
Having difficulties swallowing can make it hard to eat enough. Dysphagia is usually associated with weight loss.
Other signs and symptoms related to esophageal webs include:
- cracks around the corners of the mouth
- a sore tongue
- nasopharyngeal reflux
The cause of esophageal webs is unknown. Several factors may be involved. Some esophageal webs are inherited, or passed down genetically from parents to children.
Others are thought to be associated with iron deficiencies, developmental abnormalities, inflammation, or autoimmune disorders.
Medical conditions commonly associated with esophageal webs are described below.
Iron deficiency anemia / Plummer-Vinson syndrome
Without adequate iron, the blood cells can’t carry oxygen to the body’s tissues. This causes symptoms such as fatigue and exhaustion. Women are at an increased risk of developing iron deficiency anemia.
Plummer-Vinson syndrome (PVS) is a term used to describe iron deficiency anemia that occurs alongside dysphagia and esophageal webs or rings. It typically affects women who are middle-aged or older. PVS is associated with the development of squamous cell carcinoma, a type of skin cancer.
Research into what causes PVS is inconclusive. The link between iron deficiency anemia and esophageal webs is also unclear.
Gastroesophageal reflux disease
Some evidence suggests a link between gastroesophageal reflux disease (GERD) and the development of esophageal webs or rings. GERD causes symptoms such as heartburn and a sour or acidic taste in the back of the mouth.
How it’s diagnosed
A barium swallow is a noninvasive procedure that can help your doctor diagnose an esophageal web. It isn’t uncommon to find out you have an esophageal web after you get a barium swallow for something else.
During a barium swallow, you drink a white, chalky liquid. After, you’ll get an X-ray. The X-ray highlights the passage of the liquid through your gastrointestinal (GI) tract, making it easier for the physician to see structural abnormalities.
An upper GI endoscopy is another procedure that’s sometimes used to identify an esophageal web. During an upper GI endoscopy, a gastroenterologist or surgeon uses a flexible instrument with a camera on its tip to see the inside of your esophagus.
Your doctor might suggest other tests to check for iron deficiency anemia, or other suspected medical conditions.
How it’s treated
Treatment for an esophageal web depends on the symptoms and cause. Esophageal webs that don’t cause symptoms may not require treatment. In addition, people with mild symptoms may find that eating softer food or cutting food into smaller pieces is enough to relieve symptoms.
In cases of PVS, treatment addresses all symptoms, including iron deficiency anemia, esophageal webs, and dysphagia. Sometimes, treating iron deficiency anemia reverses changes in the esophagus and relieves dysphagia.
Esophageal dilation is another possible treatment for an esophageal web. During esophageal dilation, a doctor uses a dilator to stretch out the webbed or ringed part of your esophagus. This procedure requires a local anesthetic. You might have to stay at the hospital for a couple hours afterward, but recovery time is generally minimal.
Endoscopic procedures have also been used to treat esophageal webs. Endoscopic procedures can include endoscopic laser division or electrocautery to remove the web.
Surgery is considered a last resort in the treatment of esophageal webs.
What’s the outlook?
The outlook for people with esophageal webs with or without PVS is very good. Most people make a full recovery. Symptoms such as difficulty swallowing usually disappear completely after esophageal dilation.
Given the link between PVS and certain types of cancer, it’s important to see your doctor for a checkup on a regular basis after your treatment.