A Schatzki ring is a circular band of mucosal tissue that can form at the end of the food pipe closest to a person’s stomach. It can cause the esophagus, or food pipe, to narrow and make swallowing difficult.

When a Schatzi ring forms, it might not cause any symptoms. However, some people may have difficulty swallowing, known as dysphagia. The difficulty may worsen when a person eats dry bread or meat.

Schatzki rings are not cancerous, and they are usually harmless. Changing patterns of eating can help with the symptoms.

This article explores the symptoms and causes of a Schatzki ring. It also describes how a doctor diagnoses the condition and the treatment options available.

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A Schatzki, or mucosal, ring comprises thin tissue that develops in a circular shape in a person’s esophagus, which is the tube that carries food from the mouth to the stomach.

The ring has a small tissue fold that can block the esophagus. This can make it difficult to swallow foods or liquids. Doctors may refer to difficulty swallowing as dysphagia.

Dysphagia can cause:

  • gagging
  • a feeling of having food stuck in the throat
  • unintentional weight loss

A 2021 article notes that these rings are present in 6–14% of routine X-rays of the gastrointestinal tract.

The United Kingdom’s National Health Service (NHS) states that doctors do not know why Schatzki rings develop, but they associate it with long-term damage in people who have acid reflux.

Schatzki rings are not the only type of mucosal ring that can appear in the esophagus. There are three main types, which doctors classify according to where on the esophagus they form.

  • A rings: These are uncommon and develop above the junction between the stomach and esophagus.
  • B rings: B rings, another name for Schatzki rings, are the most common type of esophageal rings that can develop. They appear in the lower end of the esophagus, just above the junction between the stomach and the esophagus.
  • C rings: These are the least common type of esophageal ring. They form below the junction between the stomach and the esophagus.

A 2021 article notes that most people with Schatzki rings experience no symptoms. However, a person may experience difficulty swallowing.

Those with symptoms may notice the following:

  • difficulty swallowing solid foods, which may be intermittent
  • a sensation of food being caught in the throat or chest
  • heartburn

Symptoms occur when the diameter of the esophagus becomes small enough that food is unable to pass through.

According to the Schatzki rule, a Schatzki ring that measures less than 13 millimeters (mm) in diameter will always cause symptoms. Rings larger than 25 mm will generally not cause symptoms.

One possible complication of a Schatzki ring is food bolus obstruction, or “steakhouse syndrome.” This involves a ball of food completely blocking the esophagus, often when a person has not chewed it completely.

A food bolus obstruction can cause severe chest pain, and it constitutes a medical emergency. Doctors may have to use an endoscope, which is a long, flexible tube, to push or pull away the food causing the obstruction.

It is not always clear why people develop a Schatzki ring.

However, in some cases, a Schatzki ring seems to form in response to irritation when a person has acid reflux or gastroesophageal reflux disease (GERD).

The rings also appear to have an association with hiatal hernias. This type of hernia occurs when a part of the stomach moves up into the chest.

Hiatal hernias can play a role in the development of GERD and acid reflux.

A doctor will ask about a person’s symptoms and perform a physical examination.

The following tests can help the doctor confirm the presence of a Schatzki ring:

  • An X-ray with a barium swallow: This involves a person swallowing a pill containing barium contrast dye, which coats the lining of the esophagus, making the X-ray image clearer. About 6–14% of these tests show evidence of a Schatzki ring.
  • Endoscopy: In this procedure, a doctor inserts a narrow tube containing a camera into the esophagus. The camera sends images that help a doctor see whether there is an obstruction, such as a Schatzki ring.

Treatment is not always necessary if a person does not experience symptoms.

Those who do have symptoms can ease them by chewing food thoroughly and taking sips of water between bites. If a person still has trouble swallowing, certain procedures can widen the diameter of the food pipe, making swallowing easier.

Possible treatments include:

  • inserting an endoscope into the esophagus and using a blunt-tipped instrument called a bougie to widen the Schatzki ring
  • balloon dilation, which involves inserting a tiny balloon into the esophagus and inflating it to widen the ring
  • acid suppression therapy when experiencing symptoms of GERD
  • surgery to widen the food pipe

People who have a Schatzki ring can take steps to help make swallowing foods easier. These include:

  • eating small amounts of food
  • avoiding eating tough meat
  • chewing food thoroughly before swallowing

The NHS also provides some dietary tips for those with swallowing difficulties. These include:

  • cutting vegetables into small pieces
  • sitting upright while eating
  • mashing food that is not soft, such as meat and certain fruits
  • avoiding eating chewy and crunchy foods

As acid reflux or GERD may contribute to the development of a Schatzki ring, a person can try to reduce acid reflux by:

  • avoiding trigger foods, such as caffeine, coffee, and chocolate
  • avoiding spicy and particularly fatty foods
  • quitting smoking, if applicable
  • using stress management techniques to minimize stress
  • losing any excess body weight
  • changing medications that may be causing the symptoms

People should also ensure that they chew their food thoroughly and drink water frequently.

A Schatzki ring is a band of tissue that can form in the lower esophagus, causing the pipe to narrow. While some people with Schatzki rings have no symptoms, others experience difficulty swallowing. A person may also find that food becomes stuck in their throat.

A doctor will be able to determine whether someone has a Schatzki ring. They may recommend a procedure to widen the ring’s diameter.

Treatment is usually effective in providing symptom relief. However, people may require repeat dilation. Recurrence can occur in up to 64% of people within 2 years.

Lifestyle changes and acid suppression therapy can also help relieve the symptoms of a Schatzki ring.

A Schatzki ring is a circular band of mucosal tissue. It forms at the end of the food pipe and can cause it to narrow. It can result in dysphagia, which is the medical term for swallowing difficulties.

Eating soft foods, cutting vegetables into small pieces, and taking small bites may be helpful for those with swallowing difficulties.

Some people may also opt for swallowing therapy, which teaches them about positioning and swallowing techniques.