Skip to main content

Advertisement

SpringerLink
Log in

Pill esophagitis

  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Opinion statement

  • Prevention of pill esophagitis should always be pursued, particularly in debilitated, bedridden and elderly patients and those with known predisposing factors for esophageal injury (enlarged left atrium, esophageal stricture or stenosis, extrinsic compression, and so forth.). Pills should be ingested in the erect position and followed by at least 8 oz of water. After pill ingestion, patients should avoid the supine position for at least 30 minutes.

  • Making the diagnosis of pill esophagitis is very important in order to prevent re-injury. The offending drug should be identified and discontinued. For retrosternal pain and odynophagia, H2 blockers, proton pump inhibitors, sucralfate, or viscous xylocaine could be tried. However, supporting data for the efficacy of these drugs in pill esophagitis is still lacking.

  • In most patients, symptoms resolve within a few days. In a smaller number of patients with persistent, progressive or atypical symptoms or those with no history of prior pill ingestion, upper endoscopy is indicated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Kikendall JW: Pill esophagitis. J Clin Gastroenterol 1999, 28(4):298–305. This is the author’s latest update about pill esophagitis. The review includes current information about presentation, epidemiology, pathogenesis, diagnosis and therapy. Specific medications are addressed as well.

    Article  PubMed  CAS  Google Scholar 

  2. Kikendall JW: Pill-induced esophageal injury. Gastroenterol Clin North Am 1991, 20(4):835–846.

    PubMed  CAS  Google Scholar 

  3. Carlborg B, Densert O: Esophageal lesions caused by orally administered drugs: An experimental study in the cat. Eur Surg Res 1980, 12:270–282.

    PubMed  CAS  Google Scholar 

  4. Carlborg B: Complications when drugs dissolve accidentally in the esophagus and the airways [Swedish]. Svenska Lakartidningen 1976, 73:4201–4204. Of interest to clinicians.

    CAS  Google Scholar 

  5. Bonavina L, DeMeester TR, McChesney L, et al.: Drug-induced esophageal strictures. Ann Surg 1987, 206:173–183. Of interest to clinicians.

    Article  PubMed  CAS  Google Scholar 

  6. Kikendall JW, Friedman AC, Oyewole MA, et al.: Pillinduced esophageal injury: Case reports and review of the medical literature. Dig Dis Sci 1983, 28:174–182.

    Article  PubMed  CAS  Google Scholar 

  7. Carlborg B, Densert O, Lindqvist C: Tetracyclineinduced esophageal ulcers. A clinical and experimental study. Laryngoscope 1983, 93:184–187.

    PubMed  CAS  Google Scholar 

  8. Smith SJ, Lee AJ, Maddix DS, Chow AW: Pill-induced esophagitis caused by oral rifampin. Ann Pharmacother 1999, 33(1):27–31.

    Article  PubMed  CAS  Google Scholar 

  9. Minocha A, Greenbaum DS: Pill-esophagitis caused by nonsteroidal anti-inflammatory drugs. Am J Gastroenterol 1991, 86:1086–1089.

    PubMed  CAS  Google Scholar 

  10. De Groen PC, Lubbe DF, Hirsch LJ, et al.: Esophagitis associated with the use of alendronate. N Engl J Med 1996, 335:1016–1021. This article includes a detailed description of three patients who developed severe esophagitis and other adverse esophageal effects after ingesting alendronate.

    Article  PubMed  Google Scholar 

  11. Rimmer DE, Rawls DE: Improper alendronate administration and a case of pill esophagitis. Am J Gastroenterology 1996, 91:2648–2649.

    CAS  Google Scholar 

  12. Castell DO: Pill esophagitis—The case of alendronate. N Engl J Med 1996, 335:1058–1059.

    Article  PubMed  CAS  Google Scholar 

  13. Peter CP, Handt LK, Smith SM: Esophageal irritation due to alendronate sodium tablets. Possible mechanisms. Dig Dis Sci 1998, 43:1998–2002.

    Article  PubMed  CAS  Google Scholar 

  14. Van Staa T, Abenhaim L, Cooper C: Upper gastrointestinal adverse events and cyclical etidronate. Am J Med 1997, 103:462–467.

    Article  PubMed  Google Scholar 

  15. Pemberton J: Oesophageal obstruction and ulceration caused by oral potassium therapy. Br Heart J 1970, 32:267–268.

    PubMed  CAS  Google Scholar 

  16. Henry JG, Shinner JJ, Martino JH, Cimino LE: Fatal esophageal and bronchial artery ulceration Caused by solid potassium chloride. Pediatr Cardiol 1983, 4:251–252.

    Article  PubMed  CAS  Google Scholar 

  17. Indorf AS, Pegram PS: Esophageal ulceration related to Zalcitabine (ddC) Ann Intern Med. 1992, 117:133–134.

    PubMed  CAS  Google Scholar 

  18. Olovson SG, Bjorkman JA, Ek L, Havu N: The ulcerogenic effect on the oesophagus of three b-adrenoceptor antagonists, Investigated in a new porcine oesophagus test model. Acta pharmacol et toxicol 1983, 53:385–391.

    CAS  Google Scholar 

  19. Wong RKH, Kikendall JW, Dachman AH: Quinagluteinduced esophagitis mimicking an esophageal mass. Ann Intern Med 1986, 105:62–63.

    PubMed  CAS  Google Scholar 

  20. Sabil F: Topical nitroglycerin for pain relief in acute esophagitis. Gastroenterology 1994, 107(4):1215.

    Google Scholar 

  21. Saeed ZA, Winchester CB, Ferro PS, et al.: Prospective randomized comparison of polyvinyl bougies and through-the-scope balloons for dilation of peptic strictures of the esophagus. Gastrointest Endosc 1995, 41.

Download references

Author information

Authors and Affiliations

  1. Southern Arizona VA Health Care Systems (111G-1), 3601 S. 6th Ave., 85723, Tucson, AZ, USA

    Ronnie Fass MD

Authors
  1. Ronnie Fass MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fass, R. Pill esophagitis. Curr Treat Options Gastro 3, 89–93 (2000). https://doi.org/10.1007/s11938-000-0065-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11938-000-0065-0

Keywords

Search

Navigation