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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(04): 197-202
DOI: 10.1055/s-0043-1777356
Research Article

Pill Esophagitis: Clinical and Endoscopic Profile

Vikas Pemmada 
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Athish Shetty
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Megha Murali
2   Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Shiran Shetty
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Balaji Musunuri
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Siddheesh Rajpurohit 
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Ganesh Bhat 
1   Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
› Author Affiliations Funding None.
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Abstract

Background Medications can rarely cause esophageal injury and present with acute symptoms. Multiple factors, including the type of medication, comorbidity, and method of ingestion play a role in causing drug-induced or pill esophagitis (PE). We analyzed the clinical, endoscopic, and histopathological profiles of PE cases at our gastroenterology outpatient clinic.

Methods Medical records of PE cases were reviewed retrospectively over a period of 5 years at a tertiary care hospital in India from May 2017 to May 2022. The data were collected and analyzed using descriptive statistical analysis.

Results A total of 30 patients diagnosed with PE were involved in the study. A slight male preponderance of 56.7% was noted with a mean age of 40.7 years. Odynophagia was the dominant symptom (70%) with a mean duration of symptoms of 5.63 days. The most common location was at the mid-esophagus (80%) followed by the lower esophagus (10%). The majority (56.7%; 17/30) had over-the-counter (OTC) drug consumption, followed by doxycycline (33.3%; 10/30). Kissing ulcers were seen in 30% of the subjects; 90% of the patients received a combination of proton pump inhibitors and sucralfate suspension for 2 weeks along with discontinuation of the causative drug, with a 96.7% resolution rate.

Conclusion OTC medication and antibiotics such as doxycycline are the leading cause of PE. Prompt recognition and discontinuation of the causative drug are crucial in preventing complications. Patient education is vital in preventing PE regarding the usage of OTC medicines in developing countries.

Keywords

doxycycline - drug-induced esophagitis - drugs - over-the-counter - pill esophagitis - pill-induced esophagitis

Prior Publications/Presentation

Part of the study was presented as an E-poster at ENDOCON 2023, Indore, India.




Publication History

Article published online:
01 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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