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Drug-induced esophageal lesions

Lésions œsophagiennes médicamenteuses

  • Published:
Acta Endoscopica

Summary

Lesions of the esophageal mucosa induced by drugs, especially emepronium bromide (Cetiprin®) tetracyclines and potassium chloride tablets are reported with increasing frequency. The lesions are caused by esophageal retention of the drugs. Swallowing the tablets with too little fluid or while in a supine position are important contributing factors. Symptoms appear shortly after swallowing the drug. Severe retrosternal pain and odynophagia are the major symptoms. Endoscopically, confluent erosions are observed usually in the mid-esophagus potassium chloride may also produce ulcers. Withdrawal of the drug and antacid treatment are followed by rapid clinical improvement. Only ulcers caused by potassium chloride are associated with a high mortality rate due to severe complications. It is concluded that drugs should be taken with sufficient quantities of fluid and not immediately before going to bed.

Résumé

De nos jours, des lésions de la muqueuse œsophagienne dues aux médicaments tels que le bromure d’émépronium (Cetiprin®), les tétracyclines et les comprimés de chlorure de potassium sont observées de plus en plus fréquemment. Elles sont causées par le fait que les médicaments restent trop longtemps dans l’œsophage. Ces lésions sont favorisées par la prise des médicaments en position couchée et avec une quantité insuffisante de liquide. Les symptômes se présentent sous forme de douleurs rétrosternales et d’odynophagie. A l’endoscopie, on observe des érosions confluentes situées de préférence au niveau de la partie moyenne de l’œsophage. Le chlorure de potassium peut aussi produire des ulcères. L’attitude thérapeutique consiste à arrêter la prise du médicament et à prescrire un antacide. Ces mesures sont suivies d’une rapide disparition des symptômes. Seuls les ulcères dus au chlorure de potassium peuvent avoir une évolution fatale. Par conséquent il est donc recommandé d’éviter de prendre les médicaments juste au coucher et de les absorber de préférence avec une quantité suffisante de liquide.

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References

  1. BENNETT J.R. — Oesophageal ulceration due to emepronium bromide.Lancet, 1977,1, 810.

    Article  Google Scholar 

  2. BOKEY L., HUGH T.B. — Oesophageal ulceration associated with doxycycline therapy.The Medical Journal of Australia, 1975,1, 236.

    PubMed  CAS  Google Scholar 

  3. CHESSHYRE M.H., BRAIMBRIDGE M.V. — Dysphagia due to left atrial enlargement after mitral valve replacement.British Heart Journal, 1971,33, 799.

    Article  PubMed  CAS  Google Scholar 

  4. COLLINS F.J., MATTHEWS H.R., BAKER S.E., STRAKOVA J.M. — Drug-induced oesophageal injury.British Medical Journal, 1979,1, 1673.

    PubMed  CAS  Google Scholar 

  5. COWAN R.E., WRIGHT J.T., MARSH F. — Drug-induced oesophageal injury.British Medical Journal, 1979,2, 132.

    PubMed  CAS  Google Scholar 

  6. CROWSON T.D., HEAD L.H., FERRANTE W.A. — Esophageal ulcers associated with tetracycline therapy.JAMA, 1976,235, 2747.

    Article  PubMed  CAS  Google Scholar 

  7. DINES D.E., ANDERSON M.W. — Giant left atrium as a cause of dysphagia.Annals of Internal Medicine, 1966,65, 758.

    PubMed  CAS  Google Scholar 

  8. EVANS K.T., ROBERTS G.M. — Where do all the tablets go?Lancet, 1976,II, 1237.

    Article  Google Scholar 

  9. GARDIES A., GEVAUDAN J., LE ROUX C., CORNET C., WARNET-DUBOSQ J., VIGUIE R. — Ulcère iatrogène de l’œsophage.La Nouvelle Presse médicale, 1978,7, 1032.

    PubMed  CAS  Google Scholar 

  10. GIGER M., SONNENBERG A., BRÄNDLI H., SINGEISEN M., GÜLLER R., BLUM A.L. — Das Tetracyclin-Ulkus der Speiseröhre,Deutsche medizinische Wochenschrift, 1978,103, 1038.

    PubMed  CAS  Google Scholar 

  11. HABESHAW T., BENNETT, J.R. —Ulceration of mouth due to emepronium bromide.Lancet, 1972,II, 1422.

    Article  Google Scholar 

  12. HALTER F., SCHEURER U. — Verätzung des distalen Oesophagus durch ein Anticholinergikum.Zeitschrift für Gastroenterologie, 1978,16, 699.

    PubMed  CAS  Google Scholar 

  13. HENSON D. — Cytomegalovirus inclusion bodies in the gastrointestinal tract.Arch. Pathol., 1972,93, 477.

    PubMed  CAS  Google Scholar 

  14. HIGSON R.H. — Oesophagitis as a side effect of emepronium.British Medical Journal, 1978,2, 201.

    PubMed  CAS  Google Scholar 

  15. HOWIE A.D., STRACHAN R.W. — Slow release potassium chloride treatment.British Medical Journal, 1975,1, 176.

    Google Scholar 

  16. HUCHZERMEIER H., PAUL F., SEIFERT E., FRÖHLICH H., RASMUSSEN Ch.W. — Endoscopic results in five patients with Crohn’s disease of the esophagus.Endoscopy, 1977,8, 75.

    Google Scholar 

  17. KAVIN H. — Oesophageal ulceration due to emepronium bromide.Lancet, 1977,I, 424.

    Article  Google Scholar 

  18. KENWRIGHT S., NORRIS A.D.C. — Oesophageal ulceration due to emepronium bromide.Lancet, 1977,I, 548.

    Article  Google Scholar 

  19. KOBLER E., BÜHLER H., NÜESCH H.J., DEYHLE P. — Medikamentös induzierte Oesophagusulzera.Deutsche medizinische Wochenschrift, 1978,103, 1035.

    Article  PubMed  CAS  Google Scholar 

  20. KOBLER E., BÜHLER H., NÜESCH H.J., DEYHLE P. — Medikamentös verursachte Oesophagusulzera.Internistische Praxis, 1979,19, 351.

    Google Scholar 

  21. KOBLER E., NÜESCH H.J., BÜHLER H., JENNY S., DEYHLE P. — Medikamentös bedingte Oesophagusulzera.Schweizerische medizinische Wochenschrift, 1979,109, 1180.

    PubMed  CAS  Google Scholar 

  22. KUNERT H. — Medikamentös induzierte Oesophagusulzera.Deutsche medizinische Wochenschrift, 1978,103, 1278.

    PubMed  CAS  Google Scholar 

  23. LOWRY N., DELANEY P., O’MALLEY E. — Oesophageal ulceration occurring secondary to slow release potassium tablets.Irish Journal of Medical Science 1975,144, 366.

    Google Scholar 

  24. MAFFIOLI C., SEGAL S., RENARD A., DIOT J., SEGAL A. — Ulcères œsophagiens à la doxycycline.La Nouvelle Presse médicale, 1979,8, 1264.

    PubMed  CAS  Google Scholar 

  25. McCALL A.J. — Slow-K ulceration of oesophagus with aneurysmal left atrium.British Medical Journal, 1975,2, 230.

    Google Scholar 

  26. PEMBERTON J. — Oesophageal obstruction and ulceration caused by oral potassium therapy.British Heart Journal, 1970,32, 267.

    Article  PubMed  CAS  Google Scholar 

  27. PETERS J.L. — Benign oesophageal stricture following oral potassium chloride therapy.British Journal of Surgery, 1976,63, 698.

    Article  PubMed  CAS  Google Scholar 

  28. PETIGNY A., MOULINIER B. — Ulcères œsophagiens après prise de doxycycline.La Nouvelle Presse médicale, 1979,8, 439.

    PubMed  CAS  Google Scholar 

  29. ROSENTHAL T., ADAR, R., MILITIANU J., DEUTSCH V. — Esophageal ulceration and oral potassium chloride ingestion.Chest, 1974,65, 463.

    Article  PubMed  CAS  Google Scholar 

  30. SCHNEIDER R. — Doxycycline esophageal ulcers.Digestive Diseases, 1977,22, 805.

    Article  CAS  Google Scholar 

  31. SPRINGER D.J., DA COSTA L.R., BECK I.T. — A syndrome of acute self-limiting ulcerative esophagitis in young adults probably due to herpes simplex virus.Dig. Dis. Sciences, 1979,24, 535.

    Article  CAS  Google Scholar 

  32. SUTTON D.R., GOSNOLD J.K. — Oesophageal ulceration due to clindamycin.British Medical Journal, 1977,1, 1598.

    PubMed  CAS  Google Scholar 

  33. WHITNEY B., CROXON R. — Dysphagia caused by cardiac enlargement.Clinical Radiology, 1972,23, 147.

    Article  PubMed  CAS  Google Scholar 

  34. WILLIAMS J.G. — Drug induced oesophageal injury.British Medical Journal, 1979,2, 273.

    Article  PubMed  CAS  Google Scholar 

  35. ZUPPINGER A. — Pers. Mitteilung.

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Authors and Affiliations

  1. Triemli Hospital, Medical Clinic, 8063, Zurich, Switzerland

    P. Eichenberger & A. L. Blum

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  1. P. Eichenberger
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  2. A. L. Blum
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Eichenberger, P., Blum, A.L. Drug-induced esophageal lesions. Acta Endosc 10, 273–283 (1980). https://doi.org/10.1007/BF02978270

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  • DOI: https://doi.org/10.1007/BF02978270

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