“…These were once thought to be congenital, but this is unlikely since they are rarely seen before the age of 40. The association of gas troesophageal reflux and these rings was sug gested in 1978 and recently supported when 13 of 20 patients studied by ambulatory pH testing had significant gastroesophageal reflux [12], In addition LERs have been shown to occasionally progress to a typical peptic esophageal stricture [13,14], In this same report patients were noted to progress from a normal esophagus to a LER. An additional analysis challenged this concept when it com pared patients with hiatal hernia and a ring to those with hiatal hernia alone and found sig nificantly less reflux in those with both the hernia and ring [15], An attempt to correlate LER with an abnormal lower esophageal sphincter pressure found no statistical rela tionship and therefore did not support an association between LER and abnormal esophageal motility or lower esophageal sphincter pressure [16], Finally, there are no data on the effect of antireflux therapy on the recurrence of esophageal rings, although both famotidine and omeprazole have been noted to decrease the recurrence of reflux-related strictures in separate reports [17,18], A prop erly designed, randomized trial of the effect of acid suppression on the recurrence of rings is needed.…”