Clinical and endoscopic features of pill-induced esophagitis

Patel, Dhruv Kumar M.; Panchal, Yash N.; Patel, Maitri; Rajput, Sanjay; Patel, Mukundkumar V.; Patel, Madhabhai M.

doi:10.18203/2319-2003.ijbcp20220410

Cited by 1 publication

(1 citation statement)

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“…Doxycycline-induced esophageal injury ranges from erosions to deep ulcers. Cumulative incidence was 35.9% among antibiotics including doxycycline by Kim et al, and 22% in studies by Patel et al and Abid et al 10,14 A similar trend was noticed in our study as well (30%). Even in the pediatric age group, doxycycline accounted for 26% of pill-induced esophageal ulcers, as described in a Romanian series by Bordea et al 15 Only few patients developed PE secondary to NSAIDs, clopidogrel, and steroid (n ¼ 1 due to each drug).…”

Section: Endoscopic Profilesupporting

confidence: 91%

Pill Esophagitis: Clinical and Endoscopic Profile

Pemmada,

Shetty,

Murali

et al. 2023

Journal of Digestive Endoscopy

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Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology outpatient clinic. Methods Medical records of PE cases were reviewed retrospectively over a period of 5 years at a tertiary care hospital in India from May 2017 to May 2022. The data were collected and analyzed using descriptive statistical analysis. Results A total of 30 patients diagnosed with PE were involved in the study. A slight male preponderance of 56.7% was noted with a mean age of 40.7 years. Odynophagia was the dominant symptom (70%) with a mean duration of symptoms of 5.63 days. The most common location was at the mid-esophagus (80%) followed by the lower esophagus (10%). The majority (56.7%; 17/30) had over-the-counter (OTC) drug consumption, followed by doxycycline (33.3%; 10/30). Kissing ulcers were seen in 30% of the subjects; 90% of the patients received a combination of proton pump inhibitors and sucralfate suspension for 2 weeks along with discontinuation of the causative drug, with a 96.7% resolution rate. Conclusion OTC medication and antibiotics such as doxycycline are the leading cause of PE. Prompt recognition and discontinuation of the causative drug are crucial in preventing complications. Patient education is vital in preventing PE regarding the usage of OTC medicines in developing countries.

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Section: Endoscopic Profilesupporting

confidence: 91%