Schatzkiʼs Ring Detected by Esophageal Capsule Endoscopy in Patients with Chronic Gastroesohpageal Reflux Disease

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Purpose: The aim of this study is to report the prevalence of Schatzki's ring and other co-existing findings detected by esophageal capsule endoscopy (ECE). Methods: We retrospectively reviewed 1139 ECE studies performed between July 2005 to February 2011 for evaluation of chronic gastroesophageal reflux disease (GERD) symptoms. Schatzki's ring was diagnosed by the visualization of a thin ring-like structure at the distal esophagus (Image 1). Patient demographic data and ECE findings (esophageal transit time, esophagitis, and hiatal hernia) were compared for patients with Schatzki's ring versus patients without Schatzki's ring. All capsule endoscopic recordings were independently interpreted by two experienced capsule endoscopists in a blinded fashion. Results: ECE detected Schatzki's ring in 37/1139 patients (3.2%). The mean esophageal transit time, presence of esophagitis, and sex distribution were comparable in both groups. Patients with Schatzki's ring were significantly older (mean age 55.5 vs. 50.9 years old, p = 0.01) and had higher rate of hiatal hernia (91.9% vs. 37.9%, p<0.001) as compared to patients without Schatzki's ring. Of note, mean esophageal transit time was faster in patients with Schatzki's ring vs. without Schatzki's ring (115 sec vs. 160 sec, p = 0.08), though this difference was not statistically significant. Conclusion: ECE is a feasible diagnostic test to visualize Schatzki's ring in GERD patients. Schatzki's rings are associated with advanced age and hiatal hernia as compared to GERD patients without Schatzki's ring. See Table 1.Table 1Image 1: Schatzki's ring.