B ring

The B ring is a mucosal ring that develops in the distal esophagus at the gastroesophageal junction (Z line).

Terminology

If the ring becomes symptomatic, then it is usually termed a Schatzki ring, although some use the terms synonymously.

Pathology

Its development is thought to be a reaction to chronic irritation of the esophageal mucosa from gastro-esophageal reflux and it has squamous epithelium on its upper surface and columnar epithelium on its lower surface.

Associations

They are often associated with a hiatal hernia.

Differential diagnosis

• short annular peptic stricture: these tend to make a broader impression on the distal esophagus than a B ring, which is usually <5 mm in thickness