A sensory-motor theory of the neocortex.

A Schatzki ring, also known as a lower esophageal ring, is a thin, symmetric, circumferential narrowing of the distal esophagus located at or near the gastroesophageal junction. It is commonly classified as a benign B-type esophageal ring and is composed predominantly of mucosa and submucosa [,]. Although many Schatzki rings are asymptomatic, symptomatic rings are an important structural cause of intermittent solid-food dysphagia and food bolus impaction [,]. The classic presentation is episodic, non-progressive dysphagia to solids, often described as food getting stuck in the lower chest after ingestion of meat or bread. This presentation is sometimes referred to as steakhouse syndrome [,]. Ring diameter is clinically relevant because narrower rings are more likely to produce symptoms; rings less than 13 mm are usually symptomatic, whereas rings greater than 20 mm are rarely symptomatic []. Schatzki rings are frequently associated with gastroesophageal reflux disease and hiatal hernia, although the causal nature of these associations remains incompletely understood [,,,]. Atypical presentations may delay recognition, particularly when symptoms are localized to the throat rather than the lower chest. In patients with psychiatric comorbidity, throat discomfort, globus sensation, and difficulty swallowing may be misattributed to functional or psychogenic etiologies. We present a case of a Schatzki ring in a 74-year-old woman with schizophrenia who presented with globus sensation, salivary pooling, inability to swallow, and food bolus impaction. The case emphasizes the need to recognize obstructive features and avoid diagnostic anchoring.