Schatzki's Ring & Plummer Vinson Syndrome

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Schatzki's Ring and web of Plummer-Vinson syndrome are associated with difficulty in swallowing. In these diseases their is formation of thin membrane made up of Squamous epithelial cells. These membranes decrease the size of the esophageal lumen causing obstruction while ingesting food.

Schatzki's ring is more common than Plummer-Vinson Syndrome, the location of the ring is closer to lower esophageal sphincter where stomach and esophagus meet (A type Schatzki's ring) . Or the place where squamous cells of upper esophagus and columnar cells of lower esophagus meet (B Type Schatzki's ring). Dysphagia caused by Schatzki's ring is for solids and not progressive in nature. Though, there is difficulty in swallowing but pain is usually absent.

Plummer-Vinson syndrome also causes difficulty in swallowing, the location of the web formed by Plummer-Vinson syndrome is in  upper part of esophagus, closer to hypopharynx. Plummer-Vinson syndrome can progress to esophageal cancer (Squamous cell carcinoma of esophagus) and has peculiar association with iron deficiency anemia.

In both the conditions, dysphagia is intermittent and not associated with pain while swallowing.

Diagnosis

Both the conditions can easily be diagnose by barium esophagram or barium swallow. The location of the obstruction helps in differentiating between Schatzki's ring and Plummer-Vinson Syndrome.

Treatment

Treatment of Plummer-Vinson syndrome is based on treating the underlying cause which is iron deficiency anemia. Though, the ring and web can be treated by dilatation procedures, giving symptomatic relief. The dilatation process can cause gastric acid reflux which can be taken care by a short course of proton pump inhibitors.