medication-induced esophagitis; pill esophagitis
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Etiology
- medications directly injuring esophageal mucosa:
- medications diminishing lower esophageal sphincter pressure:
- risk factors
- GERD
- decreased salivary output
- large pills
- ingestion of medications in the supine position
- taking pills without adequate water ingestion.
Epidemiology
more common in the elderly
Pathology
- mid-esophageal inflammation, with sparing of distal esophagus
- associated with:
- abnormal motility
- stricture
- compression (left atrial enlargement)
- acidic environment
- decreased esophageal motility prolongs the pill contact time
Clinical manifestations
- symptoms may occur several hours after taking medication
Diagnostic procedures
- upper gastrointestinal endoscopy if conservative measures fail (see management)
Management
- stop offending medication if possible
- drink plenty of water with medication
- avoid lying down for 30 minutes after ingestion[3]
More general terms
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 284-85
- ↑ Prescriber's Letter 14(12): 2007 Drug-induced esophageal irrigation Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=231203&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2022
- ↑ Syed M. Pill-induced oesophagitis. Postgrad Med J. 2021;97:349-350. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32423921