Schatzki Ring Follow-up

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

Further Outpatient Care

  • Recurrence of dysphagia decreases with increasing experience with dilatation.
  • Repeat esophageal dilatation with a large-bore bougie in patients whose dysphagia recurs.
  • Monitor patients in follow-up visits (eg, q1-2mo) after initial dilatation and, subsequently, on an as-needed basis.
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Inpatient & Outpatient Medications

  • If reflux disease is suspected based on symptoms or endoscopic findings, consider proton pump inhibitors in addition to antireflux precautions.
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Complications

  • Esophageal dilatation for esophageal rings is well established as a safe procedure based on published series; however, potential complications include perforation and bleeding.
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Prognosis

  • Although results of dilatation are excellent, some series report that patients frequently have recurrence of dysphagia. In one study of 33 patients, 32% had recurrence at 1 year, and 89% had recurrence at 5 years.
  • No known prognostic indicators for recurrence of dysphagia exist, except for associated gastroesophageal reflux disease as reported in some studies. Other studies have refuted this contention.
  • Reassure patients that the ring is a benign entity; however, prepare them for repeat dilatation in the event of recurrence of dysphagia.
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Patient Education

  • Practitioners may advise patients to avoid eating quickly and to chew their food well, especially meat and bread.
  • Encourage antireflux precautions in patients who have associated reflux disease.
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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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