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Drug-induced esophagitis
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Drug-induced esophagitis

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Contributors: Michael W. Winter MD, Paritosh Prasad MD
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Synopsis

Drug-induced esophagitis can occur when a swallowed pill fails to fully traverse the esophagus and dissolves in the esophagus ("pill esophagitis"). It can also occur in the absence of any pill becoming lodged; drugs that have a very low pH when dissolved in saliva can cause acute gastroesophageal reflux disease (GERD), leading to esophagitis.

Pill-mediated disease often occurs at anatomical sites of narrowing including the aortic arch, left mainstem bronchus, and distal esophagus in patients with left atrial enlargement or in the setting of motility disorders or esophageal strictures. Patients often present with retrosternal chest pain, heartburn, odynophagia, and dysphagia within hours or days of ingesting the causal medication, although symptoms can present up to one month following ingestion.

Drug-induced esophagitis occurs more frequently in patients who take pills prior to lying flat or with inadequate water intake, or in patients taking a large-sized pill. Commonly implicated medications include tetracycline, doxycycline, clindamycin, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, potassium chloride, quinidine preparations, iron compounds, emepronium, alprenolol, and pinaverium.

Related Topics: Drug-induced dysphagia, Drug-induced hematemesis

Codes

ICD10CM:
K20.8 – Other esophagitis

SNOMEDCT:
47753002 – Esophagitis medicamentosa

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 01/24/2018
Last Updated: 01/24/2018
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Drug-induced esophagitis
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Drug-induced esophagitis : Dysphagia, Dyspepsia, Retrosternal chest pain
Copyright © 2018 VisualDx®. All rights reserved.