Friday, August 01, 2014

Description

This is a ring of tissue in the lower esophagus located at or near the border of the lower esophageal sphincter. It is also known as a lower esophageal ring. Being confined to the mucosa, it differs from an inflammatory (peptic) stricture, which involves all layers of the esophagus.

Causes

Schatzki's Ring is always associated with a hiatal hernia.

Symptoms

Most are over 20 millimeters in diameter and are asymptomatic. Solid food dysphagia (difficulty swallowing solid food) most often occurs with rings less than 13 mm in diameter. The dysphagia is usually intermittent and is not progressive.

Large, poorly digested food such as steak are most likely to cause problems. Drinking extra liquids or regurgitation may relieve the obstruction.

Diagnosis

Lower esophageal rings may be diagnosed clinically and confirmed by barium swallow (a radiological study to assess swallowing) and upper endoscopy (using a tube to enter the mouth in order to view the esophagus and stomach).

Treatment

The majority of symptomatic patients can be treated permanently with the passage of large (17 to 20 millimeter) dilators, which disrupt the mucosal ring. Single dilations of symptomatic lower esophageal rings are safe, easily performed, and well tolerated. Recurrences can be successfully treated by repeated dilations.

Questions

What is the approximate size of the mucosal ring?

Will it cause dysphagia (difficulty swallowing)?

What treatment do you recommend?

Is there a risk of recurrence?

Can the ring be treated again if there is a recurrence?

What is the likelihood of a permanent cure?