Drug-induced esophageal ulcers: Case series and the review of the literature

Abstract

, by excluding other factors, 48 patients were included in the study, diagnosed as drug-induced esophagitis with their history, endoscopic view, and histopathologic evaluation. Results: There were 34 (70.9%) female and 14 (29.1%) male patients in the study, and their average ages were 35.1 and 32.4, respectively. Clinical symptoms were odynophagia (79.1%), retrosternal pain (62.5%), and dysphagia (47.9%). The reason for these symptoms for 85.5% of the patients was related to insufficient water consumption while taking the pill, taking the pill in recumbent position, or both. Tetracycline and its variant, doxycycline, were responsible for 52% of the patients, and 62.5% of the drugs were in capsule form. Ulcers were at the proximal and middle third of the esophagus in 79.2% of the patients. In the histopathologic evaluation, nonspecific acute inflammatory changes were found in 29.1% of the cases. Various proton pump inhibitors and sucralfate were used in the treatment. While no perforation and structure were detected, 1 patient died because of repetitive arterial bleeding. Conclusion: Almost every kind of drug, particularly doxycycline, can cause ulcer in the esophagus. Pill esophagitis can be prevented by warning patients about drinking water sufficiently and sitting up while taking the pill.

Doxycycline induced oesophageal ulcers in a navy ship crewmember

“…Symptoms can develop between a few hours and 10 days and include odynophagia (94%), heartburn (80%) dysphagia (54%), and rarely, haematemesis, abdominal pain, and weight loss [5,6].…”

“…Although symptoms are relieved within 1 week in the majority of patients, complete resolution of the ulcers lasts up to 5 weeks. Complications such as perforation are very rare [5].…”

A rare esophagus damage reason; Ulcerative esophagitis due to usage of doxycycline

“…The most frequently implied drugs for this condition are doxycycline, tetracycline, non-steroid anti-inflammatory drugs, clindamycin, aspirin, potation chloride and alendronate sodium. [1,2] Risk factors for esophagitis after usage of drugs are taking gelatin-coated pills and capsules without sufficient amount of fluids, the quantity of the drug, and sleeping right after taking the drug. [3] Typical symptoms of medication-related esophagitis are retrosternal burning that occurs after taking drugs, pain that extends to the back and odynophagia.…”

Lysine Pill-Induced Esophageal Perforation

“…In such cases a clinical diagnosis of pill-induced esophagitis may be made. [2][3] Endoscopy is the gold standard for diagnosis of pill-induced esophagitis 4 ; however, gastrograffin swallow is used when esophageal perforation is suspected.…”

“…Endoscopic dilation may be needed subsequently in patients with an esophageal stricture. [2][3][4] When esophageal perforation is diagnosed, then expeditious operative care with debridement, repair with muscle flap, and wide drainage is done. Lately the other option is with covered stenting to prevent the operative morbidities in select patients.…”