The esophagogastric junction in patients with asymptomatic lower esophageal mucosal rings.

This study investigates whether asymptomatic lower esophageal mucosal rings are associated with a hiatus hernia or whether they represent an upward migration of columnar epithelium into the esophagus. Simultaneous manometric and potential difference measurements were performed in 12 patients with radiologically documented lower esophageal rings and in 15 control subjects. Suction biopsies from the lower esophagus confirmed that the potential difference transitional zone identified the mucosal gastroesophageal junction. In both patients and controls the esophagogastric mucosal junction was identified within or below the lower esophageal sphincter. It is concluded that the lower esophageal mucosal ring marks the lower end of the esophagus and does not represent a dislocation of the esophagogastric mucosal junction away from the lower esophageal sphincter.