title: Is the Schatzki ring a unique esophageal entity?
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Schatzki rings are frequently associated with additional esophageal disorders, which support the assumption of a multifactorial etiology. Despite typical symptoms, SRs might be overlooked.
authors: Department of Gastroenterology, German Clinic for Diagnostics Wiesbaden, 65191 Wiesbaden, Germany. mueller.gastro@dkd-wiesbaden.de
authors: Michaela
authors: M
authors: Müller
authors: Ines
authors: I
authors: Gockel
authors: Philip
authors: P
authors: Hedwig
authors: Alexander J
authors: AJ
authors: Eckardt
authors: Kathrin
authors: K
authors: Kuhr
authors: Jochem
authors: J
authors: König
authors: Volker F
authors: VF
authors: Eckardt
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D004935:Esophageal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies