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What Is a Schatzki Ring?

Medically Reviewed by Jabeen Begum, MD on November 17, 2021

A Schatzki ring is a thin ring of tissue that forms in your esophagus, the tube that connects your mouth to your stomach. The ring is noncancerous and made of tissue that lines your esophagus.

What Causes a Schatzki Ring?

Although it’s not fully clear why you get a Schatzki ring, there are a few theories. One cause might be gastroesophageal reflux disease, or GERD. This is an ongoing condition where stomach acid and contents backwash into your esophagus. 

Constant acid in your esophagus causes inflammation and damage. It’s thought that when this damage heals, it forms a scar, which is the Schatzki ring.

GERD can also lead to Barrett’s esophagus where irregular cells form in your esophageal lining. Experts think that a Schatzki ring is your body’s response to too much acid in the esophagus. It might be a natural attempt to block off acid and protect you from getting Barrett’s esophagus. 

It’s not clear that this is the case, but studies show that Barrett’s esophagus is less common in people who have GERD and a Schatzki ring. Other studies show no difference in reflux when rings are present. 

What Are Other Schatzki Ring Causes?

Other Schatzki ring causes might include:

Hiatal hernia. A Schatzki ring is commonly linked to hiatal hernia. This condition happens when the upper part of your stomach pushes through the muscle, called the diaphragm, that separates your chest and abdomen. 

Pill-induced esophagitis. Some medications can irritate your esophagus lining. One study showed that 62% of people with a Schatzki ring had also taken medications that could cause esophagitis. The research isn’t very strong, so more studies are needed.

Eosinophilic esophagitisThis condition happens when white blood cells called eosinophils build up in your esophagus and cause inflammation. Some people with this condition also have a Schatzki ring.

Plummer-Vinson syndrome. Untreated and severe iron-deficiency anemia can cause thin tissues, called esophageal webs, to grow across your upper esophagus. Some people with Plummer-Vinson syndrome also have a Schatzki ring.

What Are Schatzki Ring Symptoms?

In most cases, a Schatzki ring doesn’t cause any symptoms. If you do have symptoms, they come and go and tend not to worsen. 

The main symptom is trouble swallowing, or dysphagia. You can have:

  • Trouble swallowing pills, meat, and chewy foods
  • Trouble swallowing large bites 
  • Steakhouse syndrome, or a feeling of food stuck in your chest
  • Trouble swallowing liquids, in severe cases
  • Chest pain
  • Complete blockage where food is stuck in your esophagus
  • Regurgitation where food comes back up into your mouth 
  • Throwing up

How is a Schatzki Ring Treated?

Treatment depends on the severity of the condition and your symptoms. The main treatment is to manage any underlying health conditions and to stretch open the esophagus. Dietary changes can also help your symptoms.

Specific Schatzki ring treatments include:

Medications. If you have GERD, your doctor might prescribe an acid blocking medication called a proton pump inhibitor. This medication will lower the amount of acid your stomach makes and lead to less backwash into your esophagus. 

Esophageal dilation. In this treatment, your doctor places a tube with a camera on the end into your esophagus. After the tube is placed, they insert a balloon and inflate it. The balloon puts pressure on the area and stretches open the Schatzki ring.

After a dilation, your doctor will monitor you for a short time. You’ll be sent home within a few hours and can go back to your normal activities. You can drink fluids when the numbing wears off and you can feel your throat. After 24 hours, you can start eating again, but you might have a sore throat

You’ll usually need to take acid blocking medication after a dilation. 

Four quadrant biopsy. There are other types of dilation where they break apart the ring tissue with small tools. The tools don’t always get all of the tissue, though, which can cause the ring to come back again. 

Hiatal hernia repair. If you have a hiatal hernia, you might need surgery to push the stomach back into place and repair the diaphragm muscle.  This procedure is laparoscopic, which means it’s done with a scope and tiny camera.

Dietary changes. Making changes to your eating habits can help your symptoms. You can:

  • Take smaller bites
  • Avoid tough meat
  • Chew your food fully before swallowing
  • Take your time eating 

While some foods might trigger heartburn or worsen GERD symptoms, food itself doesn’t cause a Schatzki ring. You don’t need to take chewy foods like bread and meat out of your diet. 

Show Sources

SOURCES:

American Society for Gastrointestinal Endoscopy: “Understanding Esophageal Dilation.”

Mayo Clinic: “Hiatal hernia.”

Medscape: “Schatzki Ring.”

Memorial Hermann Foundation: “Schatzki’s Ring.”

Merck Manual: “Lower Esophageal Ring.”

University of San Diego Health: “Understanding a Schatzki Ring.”

Watts, L., Patel, K. StatPearls, “Schatzki Ring,” StatPearls Publishing, 2021.

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