Esophagitis caused by oral medication.

Teplick, J. George; Teplick, S K; Ominsky, S H; Haskin, Marvin E.

doi:10.1148/radiology.134.1.7350610

Cited by 43 publications

(20 citation statements)

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“…Alteration in stricture appearance by barium esophagram from malignant to benign after withdrawal from the causative medication, as seen in the second patient (Fig. 2b), has been previously described (Teplick et al, 1980) A number of features of the patients presented here warrant comment. In both cases, the initial diagnosis based on x-ray ( Figs.…”

Section: Discussionsupporting

confidence: 68%

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Drug-induced esophagitis simulating esophageal carcinoma

Ravich

Kashima

Donner³

1986

Dysphagia

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Abstract. Drug-induced esophagitis is an infrequently diagnosed but important cause of esophagitis. Damage to the esophageal mucosa can be severe and cause esophageal strictures that may appear malignant by radiographic and endoscopic criteria. The diagnosis requires a high index of suspicion and a careful review of the patient's drug history. Cessation of implicated drugs permits resolution of esophageal inflammation. Two patients with drug-induced esophagitis simulating esophageal carcinoma are presented.Key words: Esophagitis -Drug-induced esophagitis -Esophageal stricture -Iatrogenic injury. Case Reports Case 1A 72-year-old man was referred to the Johns Hopkins Swallowing Center for evaluation of dysphagia in 1983. Three years earlier, he had developed monthly episodes of dysphagia, with regurgitation of undigested solid food. Symptoms gradually increased in frequency and severity. By the time of referral, dysphagia occurred with every meal. The patient restricted his intake to liquids and soft, easily chewed solids. With these dietary restrictions, he was able to maintain his weight.Upper GI series and endoscopy at another hospital demonstrated a malignant-appearing stricture in the upper third of the esophagus. Despite the clinical diagnosis of esophageal carcinoma, multiple endoscopies to obtain histologic confirmation were negative for malignancy. A single cytologic Address reprint requests to:

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Section: Discussionsupporting

confidence: 68%

“…However, the intervals at which dilatations are required can be expected to decrease over time. Strictures that initially appear malignant may change to a benign appearance once medication is stopped (Teplick et al 1980). …”

Section: Discussionmentioning

confidence: 99%

Drug-induced esophagitis simulating esophageal carcinoma

Ravich

Kashima

Donner³

1986

Dysphagia

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“…In contrast, potassium chloride and quinidine tablets may cause severe chemical injury of the adjacent esophageal wall, manifested by small or large ulcers or even stricture formation [1,5,6,[14][15][16]. As previously described, retention of potassium chloride is favored in patients with underlying mitral valvular disease and an enlarged left atrium that compresses the distal esophagus.…”

Section: Pathogenesismentioning

confidence: 99%

“…As previously described, retention of potassium chloride is favored in patients with underlying mitral valvular disease and an enlarged left atrium that compresses the distal esophagus. Patients being treated with quinidine for cardiac arrhythmias can also have an enlarged heart that compresses the distal esophagus, causing retention of the quinidine tablets above this level [15,16]. As a result, esophagitis caused by potassium chloride or quinidine tends to involve the junction of the middle and distal thirds of the esophagus above the level of this cardiac impression.…”

Section: Pathogenesismentioning

confidence: 99%

Drug-induced disorders of the esophagus

Levine

1999

Abdominal Imaging

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“…Therefore, patients who take pills at bedtime without enough fluid are particularly at risk of developing MIEI as esophageal retention is then encouraged. Another risk factor predisposing for MIEI is external compression of the esophagus, due either to valvular heart disease (mostly rheumatic) with left atrial enlargement [25][26][27], or to esophageal entrapment by fixed mediastinal structures and adhesions following thoracic surgery [28][29][30].…”

Section: Medication-induced Esophageal Injury (Tables 4 5 and 6)mentioning

confidence: 99%

Drug-induced dysphagia

1993

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Dysphagia describes the disability or problems in swallowing a wet or dry bolus properly and is normally associated with an impaired transport of the bolus. Dysphagia can be accompanied by a pain sensation in the chest mostly caused by impaction of the food bolus in the esophagus. Odynophagia describes only the status of painful swallowing without an impairment of the swallow and transport function. Drug-induced dysphagia can be caused in two different ways. First as a normal drug side effect of the pharmacological action of the drug or as a complication of the therapeutic action of the drug. The normal drug side effect is most likely in drugs that affect smooth or striated muscle function or the sensitivity of the mucosa. The drug effect on smooth muscle function that causes dysphagia can be inhibitory or excitatory. Dysphagia is a common clinical symptom in patients with reduced perception of the pharyngeal mucosa which leads to an subjective impairment of swallowing. Dysphagia caused by a complication of the therapeutic action of a drug includes viral or fungal esophagitis in patients treated with immunosuppressive drugs or cancer therapeutic agents, or antibiotics and immunological reactions to certain drugs such as erythema exsudativa multiforme or Stevens-Johnson syndrome. Second, drug-induced dysphagia can be due to medication-induced esophageal injury (MIEI). In most cases this mucosal injury appears to be the direct result of prolonged contact of a potentially caustic drug with the esophageal mucosa. This form of medication-induced esophagitis is most likely to be found in elderly patients and patients with esophageal motility disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

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Esophagitis caused by oral medication.

Cited by 43 publications

References 0 publications

Drug-induced esophagitis simulating esophageal carcinoma

Drug-induced esophagitis simulating esophageal carcinoma

Drug-induced disorders of the esophagus

Drug-induced dysphagia

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