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Lower Esophageal Ring

(Schatzki Ring; B Ring)


Kristle Lee Lynch

, MD, Perelman School of Medicine at The University of Pennsylvania

Last full review/revision Oct 2020| Content last modified Oct 2020
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A lower esophageal ring narrows the lower esophagus and is most likely present at birth.

Normally, the lower esophagus has a diameter of about ¾ inch (about 2 centimeters). However, it may be narrowed to ½ inch in diameter (about 1¼ centimeters) or less by a ring of tight tissue, which may cause difficulty in swallowing solids. This symptom can begin at any age but usually does not begin until after age 25. The swallowing difficulty Difficulty Swallowing Some people have difficulty swallowing (dysphagia). In dysphagia, foods and/or liquids do not move normally from the throat (pharynx) to the stomach. People feel as though food or liquids become... read more (dysphagia) comes and goes and is especially aggravated by meat and dry bread.

Often, the ring is found when doctors look down the esophagus with a flexible tube (endoscopy Endoscopy Endoscopy is an examination of internal structures using a flexible viewing tube (endoscope). Endoscopy can also be used to treat many disorders because doctors are able to pass instruments... read more ) to look for reasons why people are having difficulty swallowing. Barium swallow X-Ray Studies of the Digestive Tract X-rays often are used to evaluate digestive problems. Standard x-rays (plain x-rays) do not require any special preparation (see Plain X-Rays). These x-rays usually can show a blockage or paralysis... read more x-rays also show the ring. In this test, people are given barium in a liquid before x-rays are taken. The barium outlines the esophagus, making abnormalities easier to see.

Chewing food thoroughly followed by taking sips of water usually prevents symptoms. A doctor may fix the narrowing by passing an endoscope through the mouth and throat and into the esophagus or may use a blunt-tipped instrument (called a bougie) to widen the passageway. In rare cases, doctors widen the constricting ring by doing a surgical procedure.

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