Table of Contents
What Is a Schatzki Ring?
The esophagus is a tube-like part that connects the mouth with the stomach. A Schatzki ring is the name given to the condition where the lower part of the esophagus becomes narrow and causes dysphagia, which means difficulty in swallowing. Dysphagia is a common condition, and the occurrence ratio is about 3 % for the overall population. The Schatzki ring consists of tissues that are present in the esophageal lining and are considered non-cancerous.
Schatzki's ring was first identified in 1944 among asymptomatic patients by a doctor named Richard Schatzki. Hence, the condition was named after the observer. The ring consists of small tissue folds, which cause a partial block in the esophagus, leading to dysphagia. Doctors and researchers believe that the Schatzki ring is one of the main causes of dysphagia of solid foods in adults.
What Are the Symptoms of the Schatzki Ring?
Most patients associated with the Schatzki ring have been presented with very few or no symptoms. One other common symptom includes the regurgitation of swallowed food. In severe cases, some might experience difficulty in swallowing solid foods. There have also been cases where the patients complained of food being stuck to the chest after eating.
As the esophagus is blocked partially, there is a possibility of chest pain as the food gets stuck in the food pipe. This condition is also called "steakhouse syndrome," as this sensation is more common when the meat is not properly chewed, whereas heartburn is also one of the common symptoms of the Schatzki ring.
The Schatzki ring was found in about 10 percent of people during routine barium swallowing studies. All the symptoms that are associated with the Schatzki ring are due to the narrowing of the esophagus. The diameter of the Schatzki ring is very important in determining the severity of the symptoms. In general, if the diameter of the ring is smaller, then the episodes of dysphagia will be more frequent than those of the Schatzki ring, which has a wider diameter.
What Are the Causes of the Schatzki Ring?
Doctors are not sure about the exact cause of the Schatzki ring. However, they have arrived at some possible reasons that might be responsible for the formation of the Schatzki ring. One such potential condition is gastroesophageal reflux disease (GERD). This is because people with Schatzki rings will often have acid reflux as well. If there is constant acid in the esophageal tract, it causes damage and inflammation in the inner lining of the esophagus. When this heals, it causes a scar, leading to the Schatzki ring. GERD can also lead to another condition called Barrett's esophagus, where the esophageal lining gets lined by irregular cells.
In addition, doctors have found the conditions that cause reflux diseases, such as hiatal hernia. It is a condition where the upper part of the stomach pushes into the muscle called the diaphragm. This muscle separates the chest and the abdomen. One other cause of the Schatzki ring is pill-induced esophagitis. Though there have not been any concrete results from studies, one particular study found that people with Schatzki rings have been taking other medications that irritate the inner lining of the esophagus.
Some other factors might also cause Schatzki ring, such as,
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Plummer-Vinson Syndrome - Untreated iron deficiency leading to anemia.
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Eosinophilic Esophagitis - Inflammation of the esophagus due to white blood cells build-up.
How Is the Schatzki Ring Diagnosed?
If a person is having trouble swallowing whole foods for a prolonged period of time, it is important to consult the doctor. The doctor will get a complete physical examination done and ask for some questions regarding dysphagia to assess the symptoms and the severity of the condition. If the person is having the feeling of food getting stuck in the chest or difficulty swallowing, it may indicate the presence of a Schatzki ring.
There are two diagnostic tests that may help to know if the esophagus is dilated or not. They are,
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Barium Swallow: In this test, the person is given a liquid and a pill that contains barium contrasts. This will dye the inner lining of the esophagus and help visualize the size of the esophagus opening with the help of an X-ray.
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Endoscopy: In this procedure, the doctor will insert a small tube into the esophagus through the mouth, where it is fitted with a camera on one side. With the help of the camera, the doctor can see the inside of the esophagus and the tissues present in the inner lining. This helps determine the Schatzki ring's presence and identify other possible causes for the dysphagia.
How Is the Schatzki Ring Treated?
The treatment of the Schatzki ring is mainly based on the severity of the symptoms and the present condition. In some cases, if the ring is caused due to other underlying health conditions, then treating them first will reduce the symptoms and help overcome the Schatzki ring. The treatments include,
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Medications: If the ring is caused due to GERD, acid-blocking medications known as proton pump inhibitors can help. They are available as prescription medicines.
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Esophageal Dilation: In this treatment, the doctor will place a camera in the esophagus with the help of a tube. Once the camera is placed, a balloon is inserted to the site of narrowing, and they are made to inflate later. This will put pressure on the area, which in turn makes the ring stretch. After this procedure, proper monitoring is required for the next 48 hours. In the meantime, they are not allowed to take solid foods, whereas liquid foods can be taken.
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Dietary Changes: Making certain changes to the way of eating might help in managing the symptoms of the Schatzki ring. They include,
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Avoiding tough meat.
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Taking small bites.
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Thoroughly chewing the food before swallowing.
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Avoid foods that trigger GERD or that cause heartburn.
Conclusion:
Schatzki ring might be a very difficult condition affecting a person's way of life, such as the food consumed, the pace of eating, etc. However, treatment is available, and there is no need for deep concern. In most cases, the Schatzki ring is present asymptomatically but becomes troublesome as the diameter of the ring decreases. With medical intervention and minor dietary changes, complete recovery from this condition is possible.
