A Large Symmetrical Esophageal Ulcer Caused by Thermal and Compressive Injury from a Solid Foodstuff Known as 'Song-Pyen'

Kim, Goeng Bae; Jeong, Jae Jin; Park, Sul; Ko, Jae Ee; Ko, Sang Hoon; Kang, Hyoun Mo; Lee, Gye Sung

doi:10.3904/kjm.2012.82.5.589

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…7 But as kissing ulcers are also found in esophageal injury other than pill-induced esophagitis, they are not pathognomonic. 19 Higuchi et al in his study discovered the etiologies of esophageal ulcers as RE (Reflux esophagitis) in 65.9% cases, pill-induced esophagitis in 22.7% cases, and infectious (viral/fungal esophagitis) in 11.4% cases. 20 If esophageal ulcers are discovered during endoscopy, reflux esophagitis or pillinduced esophagitis should be considered initially if no other disorders (example-viral/fungal esophagitis, Crohn's disease, or Levin tube injury) are suspected.…”

Section: Discussionmentioning

confidence: 99%

Clinical and endoscopic features of pill-induced esophagitis

Patel

Panchal

Patel³

et al. 2022

Int J Basic Clin Pharmacol

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Background: Medication can cause an injury in the esophagus by local and systemic effect, leading to esophagitis. Many such medications have been identified as a cause of pill-induced esophagitis. This study was performed to evaluate the clinical and endoscopic findings of pill-induced esophagitis.Methods: This was retrospective observational study, conducted among patients diagnosed endoscopically with pill-induced esophagitis at Ansh gastroenterology clinic, Ahmedabad, India, from April 2017 to March 2021. The data of these patients were recorded in pre-designed case record form by evaluating their past medical records.Results: Total 90 patients were diagnosed with pill-induced esophagitis. Retrosternal chest pain (68.9%), odynophagia (41.1%), dysphagia (25.6%), and epigastric pain (14.4%) were common clinical findings. The major culprit medications were antibiotics, and NSAIDs (non-steroidal anti-inflammatory drugs). Common esophageal endoscopic findings were ulcer (84.4%), erosion (17.8%), and active ulcer bleeding (12.2%). Kissing ulcers were observed in the majority (46.7%) of cases. The majority of ulcer and erosion were located in middle third of the esophagus. All the patients were recovered within 6 to 10 days after treatment with PPIs (proton pump inhibitors) and/or antacids, and withdrawal of the causative medication.Conclusions: Pill-induced esophagitis commonly manifests as retrosternal chest pain, odynophagia and dysphagia, and endoscopy reveals kissing ulcer and erosion in the majority of cases. The condition can be treated with PPIs and/or antacids, and withdrawal of the offending medication.

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Section: Discussionmentioning

confidence: 99%

Clinical and endoscopic features of pill-induced esophagitis

Patel

Panchal

Patel³

et al. 2022

Int J Basic Clin Pharmacol

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“…However, kissing ulcer was also found in cases other than pill-induced esophagitis. 17 Therefore, kissing ulcer alone cannot confirm pill-induced esophagitis.…”

Section: Discussionmentioning

confidence: 99%

Clindamycin-Induced Esophageal Injury: Is It an Underdiagnosed Entity?

Bestari

Agustanti

Abdurachman

2019

Clin Med Insights Case Rep

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There are increased reports of pill-induced esophagitis in the past 2 decades, with almost 100 different substances identified as the cause for more than 700 cases, and the overall incidence is estimated to be 0.004% per year. Antibiotics are one of the major contributors for these cases, especially tetracycline and doxycycline; other major contributors are bisphosphonates, nonsteroidal anti-inflammatory drugs, and iron pills. Clindamycin is commonly prescribed by physicians, yet side effect in the form of esophagitis is uncommon and mostly documented in case report. It is possible that these cases are mostly unnoticed due to initial consideration of common and more serious problems. Thus, patients may be assumed to be having a severe episode of acid reflux, and it is not routinely reported or recognized. In this case series, we presented 8 patients with clindamycin-induced esophagitis. The initial presentation of all patients was odynophagia, which appeared within the first day of taking the antibiotic. All patients were subjected to endoscopic examination and ulcer was found in all cases, in the form of localized solitary or multiple ulcers with sharply defined borders. Patients were treated with proton pump inhibitor and sucralfate, and the symptoms subside within 1 week. Patient education regarding the proper way of ingesting drug seems to be the key factor in the prevention of pill-induced esophagitis. The prevention of esophagitis is even more important with antibiotics as adverse effect would decrease the patient compliance in completing the regimen and would ultimately increase antibiotic resistance.

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“…Proximal endoscopy can confirm mucosal hyper-emia, erosions and ulcerations (solitary or multiple). The presence of "kissing" ulcer disease is more common with this form of esophagitis compared to other etiologies of the disease 34 . The lesions occurring with this disease are usually identified in the distal and middle portion of the esophagus (Fig.…”

Section: Pill-induced Esophagitis ("Pill Esophagitis")mentioning

confidence: 94%