Schatzki ring (SR)

Last reviewed 01/2018

Schatzki and Gary described a finding of contractile ring at the distal oesophagus seen on barium oesophagography performed in five patients, and their patients had dyspagia (1)

• however, they also reported that this contractile ring could be observed in patients without dysphagia
• today, this contractile ring in the distal esophagus is usually called the Schatzki ring, and it is described in major textbooks that deal with diseases of the oesophagus
• Schatzki rings are further subdivided into those above the esophagus/stomach junction (A rings), and those found at the squamocolumnar junction in the lower esophagus (B rings)

Prevalence of a lower oesophageal Schatzki ring (SR) ranges from 4%-15%, depending on the diagnostic method and population investigated

• in the majority of cases, it does not cause any symptoms, however, it is also one of the most common causes of intermittent dysphagia and food impaction
• aetiology and pathogenesis still remain unclear. Gastroesophageal reflux disease has been suggested as an aetiological factor
  • however, prospective studies have documented an association with gastroesophageal reflux disease (GORD) in less than two-thirds of patients
  • a significant proportion of patients with SRs also have eosinophilic oesophagitis (2)

Reference:

• Schatzki R, Gary JE. Dysphagia due to a diaphragm-like narrowing in the lower esophagus ("lower esophageal ring"). Am J Roentgenol Radium Ther Nucl Med 1953; 70:911-922
• Müller M et al. Endoscopic findings in patients with Schatzki rings: evidence for an association with eosinophilic esophagitis.World J Gastroenterol. 2012 Dec 21;18(47):6960-6.