Shotski's Ring

November 29, 2003

The following post was originally written January 13, 2002.

I have a shotski's ring or esophageal stricture in my throat. This is a ring like structure that causes a narrowing of the passage between my mouth and stomach. I first started having difficulties about 8 or 9 years ago. Sometimes when I would eat my throat would spasm and I couldn't swallow. It got to the point where I would have to go to the bathroom to throw up what I had just eaten. Usually this happened within one or two bites at the start of a meal.

After suffering in quiet embarrassment for a couple of years with this I finally went to a doctor. A friend was having allergic reactions to food and I thought that this must be one as well. I had one series of prick tests where upon the doctor told me I was allergic to eggs, wheat flour, rye flour, milk, cheese, and a variety of other things. It turns out that there isn't anything they can do for food allergies. You simple don't eat the foods that cause allergic reactions. With eggs, flour and milk on the list I wasn't going to be eating much. I left her office very disgusted and no closer to a solution than before.

My episodes continued and I relented and went to an internist. He ran some tests and put me on a slightly restricted diet. It turns out that caffeine is damaging to the valve at the top of your stomach. I eliminated it from my diet and did get some relief from my indigestion and reflux, but I was still throwing up. He referred me to a specialist who suspected I had this narrowing in my throat. They performed a video upper GI series and could see the stricture in my throat. Finally I knew for certain what I had.

The only treatment is to stretch the ring until it tears, allowing the throat to approach its normal diameter. The ring will grow back, sometimes very quickly, requiring another stretching procedure. The procedure is done on an outpatient basis and involves endoscopes. They run this metal tube down your throat and then insert a balloon through the tube. The balloon is inflated until the ring gives. In my case the procedure was repeated about every 5 months.

At first I got a great deal of relief from this procedure. I could eat "fear free" for several weeks before my symptoms returned. I had the stretching procedure 6 times between February 1995 and September 1997. By the end I was only getting a couple, maybe three weeks relief from the throwing up. Through out this time period I was still having tremendous difficulties with acid reflux and indigestion. My throat doctor prescribed Pepcid AC to control this.

Not satisfied with having to take pills twice a day to be comfortable, and even less comfortable with having to have surgery every 4 or 5 months I set out in search of a better solution. With my wife's assistance I began looking for alternative ways to beat this thing. I have eliminated my reflux and indigestion. I did this by taking an enzyme re-builder that is readily available in any decent health food store. Since my normal diet has never included vegetables I lacked the enzymes needed to breakdown some of the foods I was eating. These tablets, taken once a day over a two-year period, have re-built my digestive tract to where I rarely ever have indigestion. And acid reflux is a distant bad memory. Until the enzyme re-builder I hadn't had ice cream or milk in ten years. Now I have cereal several times a week, and ice cream whenever I desire.

I still am having throat episodes. I believe that they are caused by stress or tension. I am able to eat many meals each week with absolutely no difficulty. I rarely ever have trouble eating first thing in the morning. Obviously I am relaxed and rested then so my throat is relaxed as well. During the week I have my lunches out in a variety of fast food style restaurants. Some days I have reactions and some days I don't. I eat the same meals from week to week and I don't always have the same reaction. I believe that if my throat were really too narrow to swallow that it would be so for all my meals, not just some of them. Therefore some outside factor is contributing to my episodes. Most of my evening meals are eaten at home. As with lunch some nights are episode free and others are an adventure.


Today, in 2003, I have learned to manage my throat to the point where I rarely throw up completely. When I have an incident it involves thick mucus in my throat. I am usually able to cough this up in the restroom without vomiting. Since I have days or sometimes weeks without major difficulty, and it has been over six years since my last surgical procedure, I believe more than ever that whatever narrowing that may exist in my throat is not solely to blame for my difficulties.

As I have learned to manage my emotions more honestly the severity and occurrence of my throat episodes have decreased. If you are reading this and you believe you suffer from a shotski's ring I urge you to consider your entire life in addition to whatever surgical or medical treatment you feel necessary. I know that I am happy, and just as healthy without having my throat stretched as I was when I submitted to the procedure.

Life is about choices, and I choose to be in control of my own life without intervention of medical procedures. Especially those that result in no significant improvement in my overall quality of life.

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Mark H. Nichols

I am a husband, cellist, code prole, nerd, technologist, and all around good guy living and working in fly-over country. You should follow me on Twitter.