Brief Article
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World J Gastroenterol. Jun 21, 2011; 17(23): 2838-2843
Published online Jun 21, 2011. doi: 10.3748/wjg.v17.i23.2838
Is the schatzki ring a unique esophageal entity?
Michaela Müller, Ines Gockel, Philip Hedwig, Alexander J Eckardt, Kathrin Kuhr, Jochem König, Volker F Eckardt
Michaela Müller, Philip Hedwig, Alexander J Eckardt, Volker F Eckardt, Department of Gastroenterology, German Clinic for Diagnostics Wiesbaden, 65191 Wiesbaden, Germany
Ines Gockel, Department of General and Abdominal Surgery, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
Kathrin Kuhr, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, 50924 Cologne, Germany
Jochem König, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
Author contributions: All authors contributed equally to the preparation, writing, and editing of this article; all authors read and approved the final manuscript.
Correspondence to: Michaela Müller, MD, Department of Gastroenterology, German Diagnostic Clinic Aukammallee 33, D- 65191 Wiesbaden, Germany.
Telephone: +49-611-577248 Fax: +49-611-577460
Received: October 22, 2010
Revised: November 25, 2010
Accepted: December 2, 2010
Published online: June 21, 2011

AIM: To study, whether the association of Schatzki rings with other esophageal disorders support one of the theories about its etiology.

METHODS: From 1987 until 2007, all patients with newly diagnosed symptomatic Schatzki rings (SRs) were prospectively registered and followed. All of them underwent structured interviews with regards to clinical symptoms, as well as endoscopic and/or radiographic examinations. Endoscopic and radiographic studies determined the presence of an SR and additional morphological abnormalities.

RESULTS: One hundred and sixty-seven patients (125 male, 42 female) with a mean age of 57.1 ± 14.6 years were studied. All patients complained of intermittent dysphagia for solid food and 113 (79.6%) patients had a history of food impaction. Patients experienced symptoms for a mean of 4.7 ± 5.2 years before diagnosis. Only in 23.4% of the 64 patients who had endoscopic and/or radiological examinations before their first presentation to our clinic, was the SR previously diagnosed. At presentation, the mean ring diameter was 13.9 ± 4.97 mm. One hundred and sixty-two (97%) patients showed a sliding hiatal hernia. Erosive reflux esophagitis was found in 47 (28.1%) patients. Twenty-six (15.6%) of 167 patients showed single or multiple esophageal webs; five (3.0%) patients exhibited eosinophilic esophagitis; and four (2.4%) had esophageal diverticula. Four (7%) of 57 patients undergoing esophageal manometry had non-specific esophageal motility disorders.

CONCLUSION: Schatzki rings are frequently associated with additional esophageal disorders, which support the assumption of a multifactorial etiology. Despite typical symptoms, SRs might be overlooked.

Keywords: Schatzki ring, Dysphagia, Food impaction, Gastroesophageal reflux disease, Esophageal web