Schatzki ring also referred to as a narrow esophageal B-ring occurring in the distal esophagus and usually associated with a hiatus hernia. Clinical and manometric features. Our aim here was to compare the efficacy of single dilatation with a 54-F Savary dilator and electrosurgical ring incision for symptomatic Schatzki's rings. A lower esophageal ring is a 2- to 4-mm mucosal stricture that causes a ringlike narrowing of the distal esophagus at the squamocolumnar junction that often causes dysphagia. 1 It is smooth and thin (< 5 mm in axial length) and covered with squamous mucosa proximally and columnar epithelium. Although no one knows the precise cause of a Schatzki ring, experts think that hiatal hernias, GERD, and Barrett’s esophagus may all be connected. 5 mm. 21). A rings are uncommonly symptomatic. Nonprogressive and long-standing intermittent dysphagia often is caused by a lower-esophageal mucosal ring (Schatzki’s ring). [1] Esophageal webs and rings are indentations of the esophageal wall that may partially occlude the esophageal lumen. Congenital cartilaginous remnants. This topic will review the pathogenesis, clinical manifestations, diagnosis, and treatment of esophageal rings. (See also Overview of Esophageal and Swallowing Disorders . The successful use of botulinum toxin is reported on in a patient with refractory dysphagia secondary to a muscular A-ring, explaining why most patients with Schatzki’s ring respond well to esophageal dilation, while those with an A ring respond poorly. It is restricted to squamocolumnar junction at the esophagogastric junction [3-11]. Later he became a professor at Harvard Medical School. University of Medicine, Brooklyn, NY. esophageal stricture. A Schatzki ring or Schatzki–Gary ring is a narrowing of the lower esophagus that can cause difficulty swallowing (dysphagia). esophageal rings. Schatzki ring or esophageal ring are further subdivided into the ones found. Two rings have been identified in the distal esophagus. A lower esophageal ring is a 2- to 4-mm mucosal stricture that causes a ringlike narrowing of the distal esophagus at the squamocolumnar junction that often causes dysphagia. Background. In a study of 167 patients with a Schatzki ring, a hiatal hernia was detected in 97 percent . These symptoms suggest a mechanical, fixed obstruction, such as a stricture or malignancy, making an early diagnosis mandatory. The narrowing is caused by a ring of mucosal tissue which lines the esophagus or muscular tissue. Gross Ring-like narrowing of the esophageal lumen. Diagnosis can usually be made during upper gastrointestinal endoscopy by careful inspection of the esophago-gastric junction. Symptoms may occur when food gets caught at. The pathogenesis of LER is not clear, but may be related to gastroesophageal. )noun. Many approaches have been described including bougies, balloons, biopsies, and diathermic monopolar incision. This condition happens. While the majority of people with. ) The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or. Specifically, we're talking about a Schatzki ring, which requires very membranous-type dilation targets. 5% of patients with the narrowed lumen and dysphagia, these rings are pathologic. Owing to its mucosal nature, Schatzki's ring has been proposed to be caused by GERD, but no clinical association had been. Terminal esophageal web (disorder) LOMR - Lower oesophageal mucosal ring. Ring diameters in 332 patients with and without dysphagia are. endoscopy was performed in the emergency department, which revealed a distal esophageal. Schatzki ring is described as a circular membrane of mucosa and submucosa that is seen at the squamocolumnar junction of. Understanding a Schatzki Ring. 3 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 750. Schatzki R, Gary JE. GLYCOGEN ACANTHOSIS AND BARRETT'S ESOPHAGUS. ) The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or. 1 They are usually found about 2 cm above the squamocolumnar junction and their shape may vary from one case to another and is. Complex strictures are usually longer (>2 cm), angulated. SRs are sharply localized lesions. Patients classically present with intermittent dysphagia to solids. The 2024 edition of ICD-10-CM K22. Set My Location. A Schatzki ring is a thin ring of extra tissue inside the lower end of the esophagus. Evidence of GERD includes classic symptoms of pyrosis (heartburn worsens after meals or when lying flat) and extraesophageal symptoms (chronic cough, globus. Schatzki (Schatzki's) ring is. Dilation involves placing an endoscope into the esophagus and inflating an attached balloon to stretch it. Lower esophageal (Schatzki's) rings are a common cause of solid food dysphagia. Dysphagia lusoria. United States Data Schatzki ring is commonly found and can be found in. Bailey}, journal={American journal. (717) 869-4600. Am J Roentgenol 90:805, 1963 3. The ring described above is a B ring, also known as a Schatzki ring. Eosinophilic esophagitis may play a role in the pathogenesis of some patients with SR, and grossly apparent mucosal features associated with EE were significantly more common in those with EE. A Schatzki ring is a thin ring of extra tissue inside the lower end of the esophagus. 3 cm, dysphagia is present. Follow-up information was available in 56 of 61 patients (mean, 75 months). The Schatzki ring can cause a narrowing of the esophagus. Mantides A. Dysphagia lusoria. ICD-9-CM 750. 5% of patients undergoing these examinations. Disario and Peder J. The A ring is rare; furthermore, it is even more rarely associated with dysphagia. 7%), Schatzki’s rings in 15 (8. Symptomatic lower esophageal (Schatzki) rings are one of the most common causes of dysphagia and esophageal food impaction. ) The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or. radiologist, 1901–1992] A lower esophageal mucosal ring composed of a thin annular weblike tissue located at the squamocolumnar junction at or near the border of the lower esophageal sphincter. In patients with a mucosal lower esophageal ring (Schatzki's ring), the EGJ is marked by this narrowing . This medical condition is named after the German-American physician/radiologist Robert Schatzki, who first characterized it in 1953. Anatomically, it represents the lower end of the esophagus. It can cause trouble swallowing. They should not be confused with. A Schatzki ring is a thin ring of extra tissue inside the lower end of the esophagus. Next: Physical Examination. A lower esophageal ring is a narrowing of the esophagus that occurs in a small number of people. Schatzki ring is described as a circular membrane of mucosa and submucosa that is seen at the squamocolumnar junction of the distal esophagus. The cause of the problem is unclear, but many believe that it is caused by acid reflux. Although these rings are often diagnosed fluoroscopically, patients are typically referred for dilation procedures performed by a gastroenterologist. Keywords: esophageal webs, Schatzki ring, esophageal varices. December 19, 2012. ) The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or. Esophageal ring (Schatzki's ring): An esophageal ring, also known as Schatzki's ring, is a common tissue aggregation that takes the form of a ring and is found around the base of the Esophagus. The lower esophageal (Schatzki) ring is the most common cause of intermittent dysphagia and food impaction [1–3]. Pathology. If the ring becomes symptomatic, then it is usually termed a Schatzki ring, although some use the terms synonymously. 식도를 둘러싸고 있는 점막과 근육 조직의 고리로 인해 식도가 좁아진다. Practice Pearls. tients with Schatzki’s ring. Schatzki'sring was. Wolf and Richard H. The lower esophageal ring. A Schatzki ring is a tissue ring that develops in the lower esophagus that causes the esophagus’ lumen to shrink, which can make it difficult to swallow. Schatzki’s ring. They are typically located in distal esophagus but can occur in other parts of the esophagus. The ring can occur in the part of the tube near the stomach. Distal rings in the esophagus may occur in two areas. A Schatzki ring is a narrowing of the lower esophagus that can cause dysphagia. (See also Overview of Esophageal and Swallowing Disorders . The Bolster technique involves applying epigastric abdominal pressure, which may reveal a Schatzki ring that is otherwise obscured within a reduced hiatal hernia. Sealy, M. 116 The management of symptomatic Schatzki ring A report of 7 cases Malcolm Hill, MD C. agement of patients with esophageal strictures and rings. esophageal webs, which are lined on both sides by esophageal mucosa 6-8. esophageal webs, which are lined on both sides by esophageal mucosa 6-8. Diagnosis can usually be made during upper gastrointestinal endoscopy by careful inspection of the esophago-gastric junction. This images demonstrates a thin (3 mm) ring at the squamocolumnar transition at the gastroesophageal junction. Viewed many BVA decisions where 7203 can be rated separately and is not considered pyramiding. congenital disorder of digestive system. Many years ago, Schatzki described a smooth, benign, circumferential, and narrow ring of tissue in the lower end of the esophagus (the food pipe that connects the mouth to the stomach). English: Schatzki ring. The case of an 82-year-old healthy man with six months of episodic dysphagia with an SR is presented and it is shown that the former is more common than the latter. They are thought of as a pre-cancer as the risk of squamous cell carcinoma of the esophagus and pharynx is increased. Office Details. schatzki r. How is a Schatzki Ring diagnosed? The diagnosis of Schatzki ring can usually be made by barium x-ray examination of the oesophagus. A-rings, which are found a few centimeters proximal to the B-ring. Type A: lower muscular ring; rare; thickened circular smooth muscle with overlying squamous mucosa; usually 1. However, in 0. The aim of this study was to evaluate the safety and long-term efficacy of single-session graded esophageal dilation with Savary dilators, without fluoroscopic guidance, in outpatients who presented with. Schatzki's ring is a narrowing at the end of the esophagus, just above where it attaches to the stomach. A-rings, which are found a few centimetres proximal to the B-ring. subclass of. Depending on the diagnostic methods used, the prevalence of the ring ranges from 4 to 15% in adults [4–6], although its etiology and pathogenesis have not been fully eluci-dated. Important conditions in the differential diagnosis include the following [ 1] Eosinophilic esophagitis. Schatzki rings can be mistaken for fibrotic strictures of EoE and it is therefore important. Abstract. A rings are a type of distal oesophageal ring. A hiatal hernia occurs when the stomach or other organs protrude into the mediastinum through the esophageal opening of the diaphragm. Previous studies have suggested that esophageal strictures and Schatzki’s rings are the leading causes of EFI [4, 5]. DOI: 10. Standard treatment involves passage of a single large bougie to disrupt the ring, but symptoms recur in the majority of patients. (See also Overview of Esophageal and Swallowing Disorders . Endoscopic findings in patients with Schatzki rings: evidence for an association with eosinophilic esophagitis. Clinical pathological cases in gastroenterology: Esophagus. A Schatzki ring is a type of esophageal ring, which is an abnormal growth of epithelial tissue that sometimes forms around the inside of the esophagus. 5 cm proximal to squamocolumnar junction, usually asymptomatic ( Am J Gastroenterol 2000;95:43 ) Type B: lower mucosal ring / Schatzki. The ring of Schatzki is essentially a circular membrane of the mucosa and submucosa of the esophagus. A Schatzki's ring is a ring of tissue that forms inside the esophagus, the tube that carries food and liquid to your stomach. Schatzki's or lower esophageal ring (LER) is one of the most common causes of solid food dysphagia. Thirty-three. Esophageal stricture. An esophageal ring can be found anywhere along the esophagus, but it usually is found in the distal esophagus. Use of the term causes the ring to be confused with the so-called webs in the cervical esophagus, said to be associated with the Plummer-Vinson syndrome, 9 or with other definitely congenital webs of the esophagus in infants. Medical Care. They are above the B ring and occur a few centimeters proximal to the gastro-esophageal junction. L mainstem bronchus. Normally, the lower esophagus has a diameter of about ¾ inch (about 2 centimeters). Am J Roentgenol Radium Ther Nucl Med 1963; 90:805. A Schatzki ring is a specific type of "esophageal ring", and Schatzki rings are further subdivided into those above the. A Schatzki ring (SR) is a thin symmetric circumferential constriction composed of mucosa and submucosa at the gastroesophageal junction. What is a Schatzki’s Ring? Many years ago, Schatzki described a smooth, benign, 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 have also been. View. Exclusion criteria: contraindications to upper endoscopy or esophageal dilation, achalasia, scleroderma, or prior esophageal or gastric surgery, esophageal malignancy, severe esophagitis, or coagulopathy. Findings differ significantly by sex, age, and procedure. Gary. This is an abnormal ring of tissue. T h e contractile ring (Fig. Distal esophageal or Schatzki's rings are a common cause of intermittent solid food dysphagia requiring endoscopic dilation for relief. Lower esophageal rings are believed to be the most common cause of dysphagia for solids in adults []. Esophageal rings are thin mucosal structures, found most often in the distal esophagus, that occlude the esophageal lumen. It forms where the esophagus meets the stomach. Symptomatic lower esophageal rings (also known as Schatzki's rings) typically appear as smooth, symmetric ringlike constrictions at the gastroesophageal junction above a hiatal hernia [1,2,3]. Physical examination. In a study of 30 symptomatic patients with a history of a Schatzki ring, Jouhourian et al found evidence that the Bolster technique can improve endoscopic detection of Schatzki rings. Schatzki rings are almost always associated with a hiatal hernia. Causes. Although these rings are often diagnosed fluoroscopically, patients are typically referred for dilation procedures performed by a gastroen - terologist. 5 cm proximal to squamocolumnar junction, usually asymptomatic ( Am J Gastroenterol 2000;95:43 ) Type B: lower mucosal ring / Schatzki ring; 5% of. Peptic stricture is a known complication of acid reflux found in up to 8% of patients with long-standing reflux disease. Symptoms can begin at any age but usually do not begin until after age 25. The area with the ring is narrower than the rest of the food pipe. They are above the B ring and occur a few centimetres proximal to the gastro-oesophageal junction. It was first described by Schatzki and Gary in 1953 [1]. Usually in distal esophagus. Medication Summary. There are no data on the treatment. Esophageal rings can be divided into two major types: A rings and B rings. Am J Roentgenol Radium Ther Nucl Med 1963;90:805–810. Although the exact number varies, 90-100% of esophageal adenocarcinoma is thought to arise from this metaplasia. Gastroenterology 23:419,1953 6. These rings are located just above the junction between the esophagus and the stomach. The esophagus is the tube that food travels down from your mouth to your stomach. Accordingly, Schatzki's ring is sometimes found as an explanation for. Normally, the lower esophagus has a diameter of about ¾ inch (about 2 centimeters). A rings are a type of distal esophageal ring. Dysphagia due to a diaphragm-like narrowing in the lower esophagus ("lower esophageal ring"). One of the classic rings of the esophagus is actually a web; it is called a Schatzki's ring. Schatzki rings are almost always associated with a hiatal hernia. This is a specific esophageal ring with Schatzki rings being divided into subcategories. Three types of esophageal rings exist, and they are classified alphabetically as A, B, and C, as illustrated below. The association of intermittent dysphagia with lower esophageal rings was reported by Ingelfinger and Kramer and also by Schatzki and Gary in 1953. Although the endoscopic examination may be unremarkable, endoscopic features of EoE have been well-characterized and include: linear furrowing (ridges or furrows in the esophageal wall), concentric rings, white speckled exudates (eosinophilic abscesses), Schatzki ring, small-calibre esophagus, and linear superficial mucosal. A lower esophageal ring is an abnormal. Symptomatic patients typically present with intermittent dysphagia to solids. Bougienage is generally effective but relapse is common. Schatzki ring (Q628052) From Wikidata. This most frequently occurs in the presence of a lower mucosal ring (Schatzki’s ring) . Number of bottles of esophageal biopsies in the evaluation of eosinophilic. [Google Scholar] SEALY WC, YOUNG WG. 3 no CC/MCC. This can make it hard to swallow foods. 33 If a lower esophageal ring cannot be distinguished from a short peptic stricture, graded stepwise dilation is recommended. Schatzki rings (lower esophageal rings) are mostly asymptomatic. Objective: To describe the clinicopathologic characteristics of children with Schatzki ring and to determine if Schatzki ring is associated with. Gary. Marshak}, journal={Gastroenterology}, year={1960}, volume={39}, pages={634-638} }For instance, in patients with GERD, a barium swallow describes the anatomy of the esophagus and stomach (hiatal hernia, Schatzki’s ring, stricture); an upper endoscopy determines if mucosal injury is present and excludes gastric and duodenal pathology; esophageal manometry defines pressure, length, and position of the lower. submucosal venous plexus: normal structure, noted anteriorly only as slightly irregular mucosa 5; Schatzki ring: occurs in. A Schatzki’s ring is usually treated with a procedure called esophageal dilation. Statistical analysis of these measurements was performed to quantify conclusions of Schatzki and to extract additional information from the data. Standard treatment involves passage of a single large bougie to disrupt the ring, but symptoms recur in the majority of patients. Bougienage is generally effective, but relapses are common. Som and Bernard S. Dig Dis 1996; 14:323–329 3. They represent a physiological contraction of esophageal smooth muscle covered by mucosa. Malignancy (dysphagia localized to the pharynx is likely to be a referred symptom. B-Ring. Esophageal muscular A-rings, on the other hand are extremely rare. The ring can occur in the part of the tube near the stomach. A Schatzki ring is a thin ring of tissue that forms in your esophagus, the tube that connects your mouth to your stomach. Because these procedures are invasive and carry risks, including esophageal perforation, an alternative. Esophageal stricture. Esophageal webs and rings are usually asymptomatic but can occasionally present with intermittent dysphagia to solids. It was first described by. The association between menopausal hormone therapy and gastroesophageal reflux disease: a systematic review and meta-analysis. A lower esophageal ring is a 2- to 4-mm mucosal stricture that causes a ringlike narrowing of the distal esophagus at the squamocolumnar junction that often causes dysphagia. 1600 6th Ave, Suite 110, York, PA 17403. ) The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or. (WC) Microscopic. This ring makes the esophagus. Lower esophageal (Schatzki’s) ring: pathogenesis, diagnosis and therapy. They are above the B ring and occur a few centimeters proximal to the gastro-esophageal junction. 1097/00000658-196705000-00014 Corpus ID: 37575503; Experiences With The Treatment Of 59 Patients With Lower Esophageal Web @article{Postlethwait1967ExperiencesWT, title={Experiences With The Treatment Of 59 Patients With Lower Esophageal Web}, author={Raymond Woodrow Postlethwait and. Because these procedures are invasive and carry risks. Set My Location. Peptic injury secondary to chronic acid exposure accounts for 80% of all benign esophageal strictures. Other common causes of esophageal strictures are anastomotic strictures, radiation, and Schatzki ring (B-ring). Rings smaller than 13 mm in diameter almost always cause. Patients classically present with intermittent dysphagia to solids. Endoscopy. In the majority of cases, Schatzki’s ring is benign and asymptomatic; the condition is associated with hiatal hernias and can disrupt the normal. Patients classically present with intermittent dysphagia to solids. Winters GR 3rd, Maydonovitch CL, Wong RK. Anatomically, it represents the lower end of the esophagus. Gastroesophageal reflux disease has been suggested as an etiology. [1] Esophageal webs and rings are indentations of the esophageal wall that may partially occlude the esophageal lumen. These disorders include but are not limited to achalasia (cardiospasm), corkscrew and nutcracker esophagus, esophageal rings including Schatzki rings, mucosal webs or folds, and other conditions influencing motility, such as myasthenia gravis, scleroderma, and other neurological conditions. Pathology. Therefore, the aims of this study were: (1) to investigate whether the lower esophageal (Schatzki) ring is associated with other esophageal disorders; (2) to determine whether dysphagia is due to the presence of SRs or additional esophageal disorders; and (3) to determine whether one of the pathogenic theories could be supported. The pathogenesis of LER is not clear, but may be related to gastroesophageal reflux disease (GERD. Histologically, the esophageal wall consists of mucosa, submucosa, and muscularis propria. May be congenital or a scar from drinking caustic liquids. Schatzki ring is found in 6% to 14% of barium radiographs done routinely. . Schatzki's ring was confirmed on endoscopy in 59 percent of patients. This ring makes the esophagus narrow in one area, close to where it meets the stomach. In patients with symptoms of dysphagia, doctors usually also order an upper endoscope examination. Methods: Eleven patients (2 women, 9 men; median age 61 years; range. Citation, DOI, disclosures and article data. CONCLUSION. However, the remaining 20%-30% may be associated with Schatzki’s rings (SR), esophageal webs, post radiation injury, anastomotic strictures (AS) and caustic ingestion. Complications of endoscopic gastrointestinal dilation tech-Abstract. The patient is typically older than age 40 (although younger patients may be affected. A stricture is a narrowing of the esophagus (food pipe). It can stop the esophagus from stretching normally. Thus, the diagnosis of a Schatzki ring is based on both clinical and radiologic. A total of 291 EoE cases were included, mean age was 42 years. A lower esophageal ring is a 2- to 4-mm mucosal stricture that causes a ringlike narrowing of the distal esophagus at the squamocolumnar junction that often causes dysphagia. 5. 샤츠키고리는 '식도고리'(esophageal ring)의 한 형태로, 샤츠키고리는 다시 위식도접합부 위쪽에 생기는 경우(A형) 와 하부 식도의. A-rings, which are found a few centimeters proximal to the B-ring. These rings are associated with hiatal hernias and appear to be produced by an infolding at the junction between the squamous and columnar mucosa. Therapy targets underlying causes of esophageal rings and webs. 1016/S0016-5085(19)35235-7 Corpus ID: 150076966; Narrow Esophagogastric Ring Treated Endoscopically @article{Som1960NarrowER, title={Narrow Esophagogastric Ring Treated Endoscopically}, author={Max L. Hinder and Tom R. Schatzki rings are a. Abstract. What causes an esophageal ring and/or stricture? Some people may have a Schatzki’s ring since birth. These circumferential mucosal rings, which occur at the gastroesophageal junction, are associated with hiatal hernia and perhaps GERD. You may feel like food gets stuck in your esophagus. Esophageal strictures other than Schatzki ring. Schatzki's ring is a fibrous band of tissue that develops in and constricts the lower esophagus, possibly due to long-term GERD. Theories about the origin of the ring includeA Schatzki ring is a specific type of “esophageal ring”. Schatzki ring is said to be found in 6-14% routinely done barium radiographic studies. Studies have shown that Barrett esophagus is less common when a Schatzki ring is present, especially long-segment Barrett’s esophagus. 7-mm barium pill were randomized to dilatation with a 54-F Savary dilator or four quadrant. This is a common disease in medical practice. Gary. Koop AH, Middleton J, Travers PM, Ghoz H, Francis D, DeVault KR, Pang M. Am J Roentgenol Radium Ther Nucl Med. Long-term gastroesophageal reflux disease causes chronic inflammation and thus chronic damage to the lower esophagus which may result in Schatzki's Ring. Esophageal rings. A. Schatzki's ring patients who failed to pass a 12. 1 Although some patients sustain improvement after 1 endoscopic dilation, others require repeated dilations for recurrent symptoms. The esophageal rings and furrows were unchanged in six patients. Am J Roentgenol 70:911, 1953 2. Terminology. A lower esophageal ring is a 2- to 4-mm mucosal stricture that causes a ringlike narrowing of the distal esophagus at the squamocolumnar junction that often causes dysphagia. This leads to a buildup of scar tissue. Endoscopic treatment traditionally involves disruption of the ring. greater than 3 mm may be safe in simple esophageal stric-tures. The narrowing is caused by a ring of mucosal tissue (which lines the esophagus) or muscular tissue. 11). The incidence was approximately 6% to 14%. SR or esophageal "B" ring is a thin circumferential fold of mucosa found in the distal esophagus []. 2. In the article by Schatzki published in 1963, data about the lower esophageal ring relate ring diameter to presence of dysphagia. The ring is noncancerous and made of tissue that lines your. Submitted as "Mid Esophagus", Biopsy: - Squamous mucosa with basal cell hyperplasia, focal papillary elongation and abundant (predominantly basal) intraepithelial lymphocytes, see comment. Schatzki's ring patients were found to have a lower incidence of proven gastroesophageal reflux on 24-hour. These rings are associated with hiatal hernias and appear to be produced by. Similarly, eosinophilic esophagitis (EE) is a rapidly emerging disease in both children and young adults, and manifests as dysphagia to solids and/or episodic food bolus impaction. 7. Methods: Eleven patients (2 women, 9 men; median age 61 years; range. An esophageal ring, or schatzki ring, is a ring of tissue near the end of the food pipe (esophagus) just above the opening to the stomach. Dysphagia itself is rather common and occurs in about 3 percent of the. Schatzki ring is found in 6% to 14% of barium radiographs done routinely. A Schatzki ring is a thin, circumferential submucosal ring that protrudes into the lumen of the distal esophagus at the gastroesophageal junction [1, 2]. Discussion. Bougienage is generally effective but relapses are common. 2B) [18, 541. Gastrointest Endosc 2007;66:670-5. He has no other medical problems and denies any nausea, vomiting, abdominal pain, odynophagia, dysphagia, or weight loss. Heartburn and régur- gitation occurred more frequently in control patients than in Schatzki's ring patients (91 percent versus 38 percent, p <0. Schatzki’s Ring. Endoscopic treatment, particularly dilation of the esophagus with a balloon technique, is considered the standard treatment of symptomatic Schatzki's ring. The lower esophageal (Schatzki) ring is the most common cause of intermittent dysphagia and food impaction [1–3]. The etiology of lower esophageal rings is controversial; the leading theories are that they are congenital, or caused by acid reflux or pill-induced esophagitis. Its development is thought to be a reaction to chronic irritation of the esophageal mucosa from gastro-esophageal reflux and it has squamous epithelium on its upper surface and columnar. This chapter, appearing in the section on the pharynx and esophagus, reviews the definition, imaging techniques, differential diagnoses, and clinical issues of esophageal webs, rings, and varices, including the Schatzki ring. esophageal webs, which are lined on both sides by esophageal mucosa 6-8. Epidemiology. B-Ring. Image provided by David M. Rings and webs are the most common structural abnormalities in the esophagus. long term follow-up of symptomatic and asymptomatic rings.