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A Schatzki ring, also known as a Schatzki-Gary ring, is a narrowing of the lower part of the esophagus — a muscular tube through which food passes to the stomach. Schatzki ring is named after Robert Schatzki, the radiologist who first characterized it. The cause of Schatzki rings has not been firmly determined. Some doctors, however, believe that it is caused by long-term damage from stomach acid reflux or gastroesophageal reflux disease (GERD) — a condition in which stomach liquids shoot up into the esophagus, inflaming and damaging its lining. Treatment for a Schatzki ring includes fracturing with an endoscope, enlargement with a dilator, or expansion with a special balloon.
Usually, a Schatzki ring does not ignite any symptoms. Awareness, however, is usually triggered by poorly chewed food that gets stuck in the esophagus, as the patient would consequently have chest pain or have difficulty swallowing — known as dysphagia. This could compel the patient to stick a finger in the back of his or her throat to regurgitate the food — that is, to force it out through the mouth.
Typically, a Schatzki ring is diagnosed by a physician administering a barium x-ray examination or an endoscopy. A barium x-ray examination is a medical imaging procedure that is used to examine the gastrointestinal tract, which includes the esophagus and the stomach. As these tests can occasionally miss rings, an esophagogastroduodenoscopy (EGD), or endoscopy, is a better diagnostic method. Endoscopy visualizes the gastrointestinal tract from the esophagus, which is connected to one end of the stomach, to the duodenum — the upper section of the small intestine that connects to the other end of the stomach.
Unlike the barium x-ray test, endoscopy is an invasive procedure that involves insertion of an endoscope — an instrument used for examining the interior of a bodily organ — through the patient's mouth into the esophagus. This is especially helpful for patients who can neither regurgitate nor swallow food, so that obstruction can be ended as soon as possible to prevent any further chest pains and other complications. During such diagnosis, the physician can use the endoscope to check for other medical conditions, such as cancer and esophagitis.
Treatment of a Schatzki ring involves stretching or fracturing it with the endoscope, thus permitting food to move freely. Using an endoscope, however, is not the only treatment tool used. Tapered dilators can be used to enlarge the esophageal passage. Similarly, deflated balloons can be placed across the Schatzki ring and then inflated to widen it. In the most extreme cases, open surgery may be applied, although such an occurrence is exceedingly rare.
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