Schatzki Ring Clinical Presentation

  • Author: Rajeev Vasudeva, MD, FACG; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 2, 2010
 

History

  • Most patients present with intermittent, episodic, nonprogressive dysphagia to solids. Dysphagia to liquids is usually not present.
    • The episode of dysphagia appears to be short lived.
    • Typically, the patient ate a meal in a hurried fashion.
    • The bolus of food may occasionally be forced down by drinking liquids, or may be regurgitated to relieve the obstruction.
    • After forcing the bolus through or regurgitating it, the patient can usually finish his or her meal without difficulty.
    • Dysphagia may not recur for months or years in these patients. Daily dysphagia is unlikely to be caused by a Schatzki ring.
  • Bread (especially freshly baked) and meat appear to be common foods that frequently precipitate symptoms. Patients often present after rapidly eating meat and drinking alcohol at a restaurant; hence, some authorities equate Schatzki ring to the "steakhouse syndrome."
  • Associated symptoms of heartburn and regurgitation characteristic of gastroesophageal reflux disease may occur in some patients.
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Physical

  • Physical examination findings are usually unremarkable.
  • The patient may salivate and drool if the offending food bolus continues to completely obstruct the lower esophagus for a longer duration, but this scenario is excessively rare.
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Contributor Information and Disclosures
Author

Rajeev Vasudeva, MD, FACG  Clinical Professor of Medicine, Consultants in Gastroenterology, University of South Carolina School of Medicine

Rajeev Vasudeva, MD, FACG is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Columbia Medical Society, South Carolina Gastroenterology Association, and South Carolina Medical Association

Disclosure: Pricara Honoraria Speaking and teaching; UCB Consulting fee Consulting

Specialty Editor Board

Mounzer Al Al Samman, MD  Department of Internal Medicine, Division of Gastroenterology, Assistant Professor, Texas Tech University School of Medicine

Mounzer Al Al Samman, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Noel Williams, MD  Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

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Endoscopic appearance of the distal esophagus illustrating a Schatzki ring.
Barium swallow illustrating an indentation at the gastroesophageal junction consistent with a Schatzki ring above a sliding hiatal hernia.
A Schatzki ring dilated by the passage of a single large bougie.
 
 
 
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