Esophageal Rings And Webs

What Is It?

Esophageal rings and webs are thin, fragile mucosal folds that block your esophagus either partially or completely. The rings are constricting bands that form around the esophagus. Webs are thin, mucosal materials that span the inside of the esophagus. Esophageal rings and webs usually occur in the upper esophagus, and make it difficult to swallow solid food. Experts aren’t sure what causes esophageal rings and webs. They may result from chronic damage from gastroesophageal reflux (GERD). People with esophageal rings and webs commonly have reflux symptoms. The condition may be congenital (inherited) or may develop after birth. Current studies suggest a link between esophageal rings and webs and iron deficiency anemia.

Symptoms

Choking or getting food stuck in your throat is an important symptom. Meat and bread are the foods most likely to become lodged in the esophagus. You may dislodge the food by coughing or spitting it up, and then go back to your meal. Because this doesn’t happen very often when you have an esophageal web or ring, you may not realize that you have a problem.

If you have to spit up your food at every meal, you probably don’t have a ring or a web. In this case your problem may be a stricture, an abnormal narrowing of the esophagus.

Diagnosis

To determine if you have a ring or a web, your doctor may order one of these tests:

     
  • Barium swallow test - This allows the doctor to examine the esophagus with an X-ray. You will be required to swallow barium sulfate, a chalky drink.  
  • Endoscopy - Your doctor inserts a tubelike camera through your mouth into your esophagus.

If food or some other item has become lodged in your throat, these tests also will let your doctor determine what it is.

Webs are difficult to detect, and your doctor may miss them with either test. One advantage of endoscopy is that your doctor may be able to rupture the web during the process, opening up the esophagus.

Expected Duration

Treating the rings or webs usually solves your problem immediately. Webs and rings can come back, though, so you may need repeated treatments for them. Some people can live with the annoyance of rings and webs, and decide not to have treatment.

Prevention

There is no way to prevent esophageal rings or webs. However, because this condition may be related to acid reflux or iron deficiency anemia, you can take measures to prevent and treat these disorders. Avoid foods that promote acid reflux, especially coffee, chocolate, fatty foods, spicy foods, carbonated beverages, peppermint, spearmint, citrus fruits, tomatoes, whole milk and onions. The treatment of iron-deficiency anemia varies depending on the cause of the problem.

Treatment

Most likely, your doctor will uses a technique called dilation to correct your esophageal ring or web. Dilation involves stretching or widening the narrowed part of the esophagus. Usually your doctor will dilate your esophagus with a specially designed balloon that will be inserted in the appropriate part of your esophagus. The balloon will then be inflated to stretch the rings and break up the webs.

A few people have rings in the lower esophagus that don’t improve even after repeated dilation therapy. In this case, you may be treated with steroid injections or surgery.

If you have rings or rings that keep coming back, and you have other evidence of reflux, your doctor may prescribe medication to treat reflux. Because anemia may contribute to the development of esophageal rings and webs, your doctor probably will check for anemia and, if necessary, treat it.

When To Call A Professional

You should seek medical attention right away if you have difficulty swallowing.

Prognosis

Once the doctor corrects the stricture or obstruction, the problem should go away. If you have iron-deficiency anemia, you will need to be treated for that problem before the problem goes away.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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