What is Schatzki's ring?
Schatzki (Schatzki's) ring is described as a smooth, benign (non-cancerous), circumferential, and narrow ring of tissue in the lower end of the esophagus (the food pipe that connects the mouth to the stomach). Schatzki rings are common and are located just above the junction of the esophagus with the stomach.
What is the cause of Schatzki's ring?
The cause of Schatzki rings is not clearly understood. Some doctors believe they are caused by long-term damage from reflux of stomach acid (gastroesophageal reflux disease, GERD).
What are the symptoms and signs of Schatzki's ring?
The majority of these rings cause no symptoms, and people do not know they are there. As the diameter of these rings shrinks; solid, poorly chewed food, for example, steak, turkey, or hotdogs, that stays in chunks can get caught at the level of the ring. This occurs when the diameter of the ring reaches approximately 1 cm (0.4 inches).
- The person with the Schatzki ring then experiences chest pain or a sticking sensation in the chest with swallowing (referred to as dysphagia).
- When the chunk of food passes into the stomach, symptoms subside quickly and the person can resume eating.
- If the food does not pass into the stomach, some people have to induce regurgitation of the food by sticking their fingers in the back of their throat before they can begin eating.
Rarely, food becomes impacted (the food cannot pass nor can it be regurgitated). Symptoms of impacted food in the throat include:
- Chest pain
- Difficulty swallowing
- Decreased saliva
- Secretion production
A flexible endoscope has to be inserted through the mouth into the esophagus to extract the impacted food to relieve the obstruction.
SLIDESHOW
Acid Reflux (Heartburn, GERD): Symptoms & Remedies See SlideshowHow is Schatzki's ring diagnosed?
The diagnosis of a Schatzki ring can usually be made by barium X-ray examination of the esophagus; however, a narrow ring can be missed on X-ray. In patients with symptoms of dysphagia, doctors usually also order an upper intestinal endoscopy examination.
Endoscopy
Endoscopy is the best way of diagnosing a Schatzki ring.
- During the endoscopy, a flexible viewing tube is inserted through the mouth into the esophagus.
- It allows a direct view of the inner lining of the esophagus and the stomach.
- The test helps to exclude early cancer, esophagitis, and Barrett's esophagus which also may cause narrowing of the esophagus.
What treatment is for Schatzki's rings?
Treatment and management of the condition include procedures that will stretch or fracture the rings, which will allow solid food to pass through the esophagus more freely.
- Schatzki rings can be stretched or fractured with endoscopes or tapered dilators inserted through the mouth.
- They also can place deflated balloons across the ring and then inflate them.
- Occasionally, Schatzki rings may be cut with an electrocautery probe.
- Rarely, surgery is necessary to treat Schatzki rings.
Can Schatzki's ring be cured?
There is no cure for Schatzki rings.
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Chest Pain
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis.
Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Chest Pain or Heart Attack Quiz
What causes chest pain? If you have chest pain, does it mean you're having a heart attack? Take the quiz to learn what diseases and conditions may be responsible for pain in your chest.
Endoscopy (EGD) Procedure
Endoscopy is a broad term used to described examining the inside of the body using an lighted, flexible instrument called an endoscope. Endoscopy procedure is performed on a patient to examine the esophagus, stomach, and duodenum; and look for causes of symptoms such as abdominal pain, nausea, vomiting, difficulty swallowing, or intestinal bleeding.
Esophagitis
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include a candida yeast infection of the esophagus as well as herpes. Signs and symptoms of esophagitis include cough, mouth sores, chest pain, bad breath, sore throat, heartburn, and difficulty swallowing. Treatment of esophagitis includes diet, lifestyle changes, and medication depending upon the cause.
Fundoplication (Acid Reflux Surgery)
Fundoplication is a surgical procedure for treating GERD (gastroesophageal reflux disease). The procedure is to help GERD symptoms including heartburn. Eighty percent of patients with GERD also have a hiatal hernia, and during the fundoplication procedure, the hernial sac may also be surgically fixed. The procedure can be done with laparotomy, thoracotomy, or laparoscopy.
GERD Picture
The stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by stomach acid and enzymes. See a picture of Gastroesophageal Reflux (GERD) and learn more about the health topic.
GERD (Acid Reflux, Heartburn)
Gastroesophageal reflux disease (GERD), also called acid reflux, can cause symptoms like heartburn, chest pain, regurgitation, and nausea. Learn about causes, diagnosis, treatment and prevention.
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Who is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about it.
Heartburn
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest.
Causes of heartburn include dietary habits, lifestyle habits, and medical causes.
Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
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Learn the symptoms of heartburn and which foods cause heartburn or GERD. Discover home remedies and which foods may provide treatment for heartburn relief.
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include:
- Belching
- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Belching
- Wheezing
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- Indigestion
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Pregnancy
- Diabetes
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
REFERENCES:
American College of Gastroenterology. "Acid Reflux." 2017.
<http://patients.gi.org/topics/acid-reflux/>
familydoctor.org. "Heartburn." Updated: Mar 2014.
<https://familydoctor.org/condition/heartburn/>
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
<https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072436/>
Swallowing Problems (Dysphagia)
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
The Digestion Process (Parts, Organs, and Functions)
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Upper GI Series (Barium Swallow)
An upper gastrointestinal GI series, or barium swallow is a test used in assisting in the diagnosis of upper gastrointestinal diseases or conditions such as ulcers, tumors, hiatal hernias, scarring, blockages, and abnormalities of the muscular wall of the GI tract.