Lower esophageal ring

Esophagogastric ring; Schatzki's ring; Dysphagia - esophageal ring; Swallowing problems - esophageal ring

A lower esophageal ring is an abnormal ring of tissue that forms where the esophagus (the tube from the mouth to the stomach) and stomach meet.

Causes

A lower esophageal ring is a narrowing of the esophagus that occurs in a small number of people. The cause of the problem is unclear, but many believe that it is caused by acid reflux.

Narrowing of the esophagus may also be caused by:

Injury
Tumors
Esophageal stricture
Esophageal stricture
Benign esophageal stricture is a narrowing of the esophagus (the tube from the mouth to the stomach). It causes swallowing difficulties. Benign mean...
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Symptoms

For most people, a lower esophageal ring does not cause symptoms.

The most common symptom is the feeling that food (especially solid food) is stuck in the lower neck or under the breastbone (sternum).

Exams and Tests

Tests that show the lower esophageal ring include:

EGD (esophagogastroduodenoscopy)
EGD
Esophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine (the duodenum)....
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Barium swallow (x-ray with barium)
Barium swallow (x-ray with barium)
An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...
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Treatment

A device called a dilator is passed through the narrowed area to stretch the ring. Sometimes, a balloon is placed in the area and inflated, to help widen (dilate) the ring.

Outlook (Prognosis)

Swallowing problems may return. You may need repeat treatment.

When to Contact a Medical Professional

Contact your health care provider if you have swallowing problems.

Open References

References

DeVault KR. Symptoms of esophageal disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 13.

Madanick RD, Kaila V. Anatomy, histology, embryology, and developmental anomalies of the esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 43.

Schatzki ring - x-ray - illustration
A solution containing a dye (barium), which is visible on x-rays, has been swallowed (upper GI series) and x-rays have been taken of the esophagus. There is a narrowing near the stomach (indicated by the arrow). This non-cancerous ring of tissue (Shatzki ring) may cause swallowing problems (dysphagia) and can be treated with dilation of the stricture.
Schatzki ring - x-ray
illustration
Upper gastrointestinal system - illustration
The upper gastrointestinal organs include the mouth, esophagus and stomach.
Upper gastrointestinal system
illustration

Schatzki ring - x-ray - illustration
A solution containing a dye (barium), which is visible on x-rays, has been swallowed (upper GI series) and x-rays have been taken of the esophagus. There is a narrowing near the stomach (indicated by the arrow). This non-cancerous ring of tissue (Shatzki ring) may cause swallowing problems (dysphagia) and can be treated with dilation of the stricture.
Schatzki ring - x-ray
illustration
Upper gastrointestinal system - illustration
The upper gastrointestinal organs include the mouth, esophagus and stomach.
Upper gastrointestinal system
illustration

A Closer Look

Talking to your MD

Self Care

Tests for Lower esophageal ring

Review Date: 10/31/2022

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Lower esophageal ring

Causes

Esophageal stricture