What is a Schatzki 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 of a Schatzki ring?
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 causes Schatzki 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.
Diagnosing a Schatzki ring
Your doctor may begin by asking you some questions regarding your dysphagia. Some examples include:
- How do you feel when you try to swallow?
- What kind of foods do you have difficulty swallowing? Liquids, solids, or both?
- Are there any additional symptoms associated with your difficulty swallowing?
The feeling of food getting stuck in your chest as well as difficulty swallowing solid foods could indicate the presence of a Schatzki ring.
In cases where your doctor suspects a narrowing of your esophagus, they may choose to perform an endoscopy. During this procedure, your doctor places a small tube with a camera attached into your esophagus. This allows the doctor to see the tissue of the esophagus and can help in determining if there is a Schatzki ring or other structure present that could be causing the dysphagia.
A barium swallow may be performed as well. For this test, you swallow liquids as well as a pill that contains a barium contrast. The dye coats the lining of your esophagus and can be visualized in an X-ray. Your doctor can then use the images that are generated from the X-ray to see if a Schatzki ring is present in your esophagus.
Treatment for a Schatzki 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.
Changes to eating patterns
A Schatzki ring often leads to difficulty in swallowing solid foods, so it’s important to make sure that you eat slowly and chew all food thoroughly before swallowing. It may also be helpful to take in a smaller amount of food per bite. Additionally, changing the food that you eat to avoid consumption of large or tough items may help you avoid a food blockage of the esophagus.
Outlook for a Schatzki ring
A Schatzki ring is a narrowing of the lower esophagus and the leading cause of dysphagia of solid foods in adults. Schatzki rings are often asymptomatic. Typically, symptoms occur when a Schatzki ring is of a small diameter. These symptoms include:
- difficulty in swallowing solid food items
- feeling as if food is getting stuck in your chest
Your doctor can perform an examination that includes an endoscopy, a barium swallow, or both tests to determine if a Schatzki ring is present. Symptoms can be alleviated by a balloon dilation procedure that expands the diameter of the Schatzki ring. Additionally, acid suppression therapy has also been shown to be effective.