Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Drug-Induced Esophagitis

  • Mário Ferraz de OliveiraEmail author
Reference work entry


Drug; Iatrogenic; Medication-induced esophagitis; Pill


First described in 1970 by Pemberton, drug-induced esophagitis is an underdiagnosed entity, which affects all ages but is more frequent in the elderly (specially women).

It is caused by attached and prolonged mucosal contact of the ingested tablets/capsules with posterior damage to the mucosa due to the following mechanisms: production of a caustic solution (acidic or alkaline), creation of a hyperosmolar solution, or direct drug toxicity.

The patients normally have no previous esophageal pathology, although some cases are related with decreased salivary flow, esophageal motility abnormalities, or extrinsic compression. The more common causes are ingested pills with either very little fluid or without, before night time sleep, or other recumbent positions.

The common symptoms are odynophagia, retrosternal pain, and dysphagia, which start a few hours or days after the ingestion of the pill, sometimes with...

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References and Further Reading

  1. Arora, A. S., & Murray, J. A. (2000). Iatrogenic esophagitis. Current Gastroenterology Report, 2(3), 224–229.CrossRefGoogle Scholar
  2. Jaspersen, D. (2000). Drug-induced oesophageal disorders: Pathogenesis, incidence, prevention and management. Drug Safety, 22(3), 237–249.CrossRefGoogle Scholar
  3. Kikendall, J. W. (1999). Pill esophagitis. Journal of Clinical Gastroenterology, 28(4), 298–305.CrossRefGoogle Scholar
  4. Noffsinger, A. E. (2009). Update on esophagitis-controversial and underdiagnosed causes. Archives of Pathology and Laboratory Medicine, 133, 1087–1095.PubMedGoogle Scholar
  5. Young, P. E., & Kikendall, J. W. (2012). Pill-induced esophageal injury. In J. E. Richter & D. O. Castell (Eds.), The esophagus (pp. 707–724; 5th ed.). Wiley-Blackwell.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Serviço Anatomia PatológicaCentro Hospitalar Lisboa Central EPELisbonPortugal