What causes lower esophageal ring?

The exact cause of lower esophageal ring (LER) is not fully understood, but several factors are believed to contribute to its development:

1. Muscle contraction abnormalities: The muscles of the lower esophagus, known as the esophageal sphincter, can develop abnormal contractions or spasms. These contractions can cause the formation of a ring-like structure that narrows the esophageal lumen.

2. Esophageal inflammation: Chronic inflammation of the esophagus, such as that caused by gastroesophageal reflux disease (GERD), can lead to the development of LER. Inflammation can cause thickening and scarring of the esophageal tissue, resulting in the formation of a ring.

3. Muscle herniation: A small portion of the stomach can herniate or bulge upward through a weak area in the diaphragm (hiatal hernia). This can cause the lower esophageal sphincter to become displaced, leading to the formation of LER.

4. Eosinophilic esophagitis: This is a chronic inflammatory condition of the esophagus characterized by an increased number of eosinophils, a type of white blood cell. Eosinophilic esophagitis has been associated with the development of LER in some cases.

5. Structural abnormalities: In rare cases, LER can be caused by structural abnormalities in the lower esophagus, such as a congenital narrowing or a web-like membrane.

It's important to note that LER can occur in both adults and children, although it is more common in adults. The condition often goes undiagnosed or is misdiagnosed as other esophageal conditions, such as GERD. Proper diagnosis and management by a healthcare professional are essential to alleviate symptoms and prevent complications.