Drug-induced esophagitis
Alerts and Notices
Synopsis
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:K20.80 – Other esophagitis without bleeding
SNOMEDCT:
47753002 – Esophagitis medicamentosa
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- GERD not related to oral medication
- Esophageal carcinoma
- Esophageal foreign body
- Scleroderma
- Achalasia
- Atypical angina (see acute coronary syndrome, coronary artery disease)
- Eosinophilic esophagitis
- Esophageal web or stricture
- Esophagitis: reflux, infectious, radiation
- Crohn disease or Behçet disease with upper gastrointestinal tract involvement
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.Subscription Required
References
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Last Reviewed:01/23/2018
Last Updated:09/16/2020
Last Updated:09/16/2020