Those who have esophageal rings and webs are usually unable to swallow or drink large amounts of liquids. They may have to pass a small amount of liquid or food through a tube called a nasogastric tube. The tube is very thin and is attached to the esophagus by a tiny valve. The valve is designed to prevent food from being stuck in the esophagus. This valve can be damaged or deformed over time.
Treatment
Symptoms of esophageal rings and webs can vary. In some cases, the patient may experience only intermittent dysphagia, while in others, the symptoms may be severe. In either case, treatment is necessary. In some cases, surgery is necessary for permanent treatment of esophageal webs and rings.
Symptoms of esophageal webs can include regurgitation of food, difficulty swallowing, and choking sensation. The symptoms can also occur in people who have other gastrointestinal disorders, such as gastroesophageal reflux disease (GERD) or autoimmune disorders. These symptoms can be a sign of a refractory esophageal web, in which case repeat esophageal dilation and electrocautery will help dilate the web.
Webs and rings can be acquired or congenital. In some cases, the webs and rings may be related to inflammation. In other cases, they may be related to a developmental abnormality.
Upper esophageal webs are usually idiopathic. They can be treated with endoscopic biopsies, endoscopic laser division, or surgical resection. In some cases, esophageal webs have been associated with cutaneous disorders.
Lower esophageal rings are usually asymptomatic. They may develop spontaneously or as a result of gastroesophageal reflux. When they do develop, the symptoms are usually related to intermittent dysphagia to solid food. Patients who are suffering from this condition are recommended to eat smaller bites of food. It is important to chew food well to avoid food getting stuck in the esophagus.
Dysphagia to solid food is the most common complication of esophageal rings and Webs. Patients are often asymptomatic, and dietary modifications, including eating smaller bites, have been effective.
Symptomatic esophageal rings and webs usually respond to dietary changes and modification of physical activity. However, they may require electrocautery or surgery. The severity of the symptoms will depend on the size of the blockage.
Diagnosis
Symptoms associated with esophageal rings and webs may include difficulty swallowing food, weight loss, bloody stools, and the feeling of choking while swallowing food. The condition may be congenital or acquired. There are different theories about the origin of the condition, but it is generally believed to be related to developmental abnormalities, autoimmunity, or iron deficiency anemia.
An esophageal ring or web can occur anywhere in the esophagus. They are a thin, membranous fold of tissue that narrows the esophagus and make it difficult to swallow. Symptoms can vary depending on the size of the blockage. Symptoms can be recurrent and can affect a person’s quality of life.
Barium swallows can be used to diagnose esophageal rings and webs. They may also be identified by upper endoscopy. Although this procedure is less sensitive than barium esophageal radiography, it is effective in identifying the presence of these lesions.
Barium esophageal gram (BEG) is useful in diagnosing esophageal rings and webs, but it does not detect other causes of dysphagia. The esophageal lumen must be at least 13 millimeters in diameter to be able to have a proper diagnosis.
The main diagnostic criteria for esophageal rings and webs are difficulty swallowing solid food and the presence of a blockage in the esophagus. If these criteria are met, upper endoscopy is usually recommended to confirm the diagnosis.
Barium swallow can also be used to diagnose the presence of a cervical web, which is a very thin fold of tissue that is located on the upper end of the esophagus. The presence of a web in the upper esophagus has been linked to iron deficiency anemia.
Etiology
Various theories have been put forth to explain the etiology of esophageal rings and webs. These include developmental abnormalities, autoimmune disorders, and anatomic lesions of the esophagus. Regardless of the specific cause, the condition has a good prognosis. However, the etiology of these lesions remains controversial.
Most esophageal rings and webs are acquired, but they can also be congenital. The main presenting symptom of these lesions is dysphagia. Symptoms can include difficulty swallowing solids and liquids, pain, indigestion, and weight loss. Symptoms are relieved by esophageal dilatation. For some, it may require repeat dilations to alleviate symptoms.
There are three common types of anatomic lesions of the esophagus: esophageal rings, esophageal webs, and esophageal diverticula. This review will discuss their etiology, pathophysiology, and diagnostic and treatment options.
There are two common types of esophageal rings: the A ring and the B ring. The A ring is present near the squamocolumnar junction and is formed by normal smooth muscle contraction. The B ring is a smooth, thin ring with columnar epithelium proximally and squamous epithelium laterally.
Although esophageal rings and webs have a good prognosis, they can have complications. Some complications include nonpathologic indentation of the esophagus, weight loss, and bleeding. In addition, patients with these lesions may require aggressive treatment for gastroesophageal reflux. If this occurs, a proton pump inhibitor may be prescribed. In some cases, esophageal surgery may be required.
In addition to dysphagia, people with esophageal webs may also experience difficulty swallowing. In rare cases, they may develop a stricture. Symptoms of dysphagia can be treated by altering diet and taking medications.
Endoscopy is the best test to diagnose esophageal rings and webs. However, it is less sensitive than barium radiography.
Symptoms
Symptoms of esophageal rings and webs vary depending on the size of the blockage. Some patients may experience difficulty swallowing and regurgitation of food. Others may not experience any symptoms. However, if the esophagus is completely blocked, no swallowing will occur. If you experience any of the above symptoms, seek medical attention immediately.
These structures are composed of thin membranes that partially block the esophagus. They can be formed anywhere in the esophagus. They are generally found in the upper esophagus.
They are caused by gastroesophageal reflux disease (GERD), a condition where stomach acid backs up into the esophagus. They may cause heartburn, regurgitation of food, and difficulty swallowing.
They can also be associated with iron deficiency anemia, autoimmune diseases, and developmental abnormalities. They can be diagnosed by barium radiographs and esophageal endoscopy. They can be treated by dilation or esophageal surgery.
The most common symptoms of esophageal rings and rings and webs are dysphagia (difficulty swallowing solid food) and regurgitation of food. If a person is experiencing these symptoms, it is best to see a gastroenterology doctor. They may prescribe medications and change the person’s diet to help alleviate these symptoms. If the symptoms are severe, electrocautery or surgery may be needed.
When barium radiographs do not reveal any obstruction, upper endoscopy may be used to diagnose esophageal rings. It is less sensitive than barium radiography. A gastroenterology doctor may insert an endoscope carefully into the esophagus. This will allow him to identify any lesions or malignancies. He can biopsy these lesions if necessary.
A gastroenterology doctor may be able to treat the condition by dilatation or surgery. He may also recommend acid-suppression medications and diet changes.
Prevention
During an esophageal endoscopy, the radiologist examines the esophagus from the inside using a tube-like camera. If the esophagus is found to have a web or a ring, the blockage can be removed.
Webs can cause difficulty swallowing food and other substances. They are thin pieces of tissue that can narrow the esophagus. In some cases, the web completely blocks the esophagus. The blockage causes food to be trapped and creates irritation. The condition can be asymptomatic. However, it can cause weight loss and dysphagia.
Webs and rings may be associated with iron deficiency anemia. Iron deficiency anemia causes fatigue and exhaustion. This is a condition that can be treated by eating a healthy diet. The condition can also be treated in an inpatient or outpatient setting.
Webs and rings can be treated with esophageal dilatation. These procedures are performed with a long, flexible tubular instrument called a dilator. They can be very effective at disrupting the webs, but they should be performed carefully.
A ring is less common than webs and rings. These bands of tissue are more likely to form at the junction between the stomach and esophagus. The most common type of esophageal ring is the Schatzki ring. Other types of esophageal rings are C rings and B rings.
If an esophageal ring or web causes you trouble swallowing, see your doctor immediately. You may need to undergo electrocautery or another procedure to unblock the esophagus. You may also need to modify your diet. Taking smaller bites and eating soft foods may help. You can also drink water to ease symptoms. If your symptoms are severe, you may need to be hospitalized.
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