Iatrogenic reflux oesophagitis

Abstract

SummaryA report on two patients with severe reflux oesophagitis caused by Emepromium Bromide (‘CETIRPIN’) prescribed for the treatment of urinary symptoms.Emepronium Bromide is a quaternary ammonium anticholinergic drug, which blocks the peripheral cholinergic nerves and ganglionic transmission. In man it increase bladder capacity, delays the first desire to void and decreases voiding pressure.In the last eighteen months two patients have been referred with severe pain on swallowing. The pain was localized behind the sternum and reached down to the epigastrium. On both occasions the symptoms came on rapidly a few days after the treatment was begun. Both patients were on a standard dose of 200 mgs. three times daily. The first patient had had some minor reflux with her last pregnancy thirteen years previously, but otherwise no symptoms suggestive of reflux. The second patient had never has any symptoms suggestive of oesophageal reflux. In both patients a major feature was the severity of their pain.

Medication-Induced Oesophageal Injury

“…Some investigators have postulated that emepronium bromide promotes gastro-oesophageal reflux and thereby produces oesophagitis (Shepperd 1977). Neither endoscopy nor barium swallow was performed in 13 of these patients.…”

Drug-induced corrosive injury of the oesophagus

“…X-ray of the oesophagus was performed on all patients, but neither hiatus hernia nor gastrooesophageal reflux was shown in any of the cases. Recently two cases have been presented in the literature in which Cetiprin R was suspected of having caused iatrogenic reflux oesophagitis (Shepperd, 1977). None of the patients reported vomiting.…”