Esophagogastric ring

Alternative names
Lower esophageal ring (Schatzki); Schatzki’s ring

A lower esophageal ring is an abnormal ring of tissue located at the junction of the esophagus (the tube from the mouth to the stomach) and the stomach, which can cause swallowing problems.

Causes, incidence, and risk factors

Physicians disagree on the cause of this disorder, unless it obviously follows ingestion of caustic material such as lye or strong acids. It may be a congenital defect (present from before birth). Alternatively, it may be related to chronic injury caused by gastroesophageal reflux disease (GERD), in which stomach acid leaks into the esophagus and irritates it.

Esophageal rings are known to occur from drinking a caustic substance, causing scar tissue. The condition may produce swallowing difficulties.


  • Difficulty swallowing  
  • Chest pain under the sternum (breastbone)

Signs and tests
Tests that show the lower esophageal ring include:

  • An EGD (esophagogastroduodenoscopy)  
  • A barium swallow


Initial treatment typically consists of dilating (stretching) the ring by passing a dilator or balloon through the ring. Any associated reflux should also be treated. Surgical cutting (excision) of the ring may be necessary if dilation is unsuccessful.

Expectations (prognosis)

It is possible that the difficulty swallowing may return, and repeat dilation may be necessary.


There are usually no complications except for the noted difficulty swallowing and chest pain.

Calling your health care provider

Call for an appointment with your health care provider if symptoms suggestive of this disorder develop, to rule out other causes of the symptoms and to determine the best treatment for you.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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