Drug-Induced Oesophageal Disorders: Pathogenesis, Incidence, Prevention and Management

Author: Jaspersen D.

Source: Drug Safety, Volume 22, Number 3, March 2000 , pp. 237-249(13)

Publisher: Adis International

Abstract:

Drug-induced injury of the oesophagus is a common cause of oesophageal complaints. ‘Pill-induced’ oesophagitis is associated with the ingestion of certain drugs and accounts for many cases of erosive oesophagitis. To date, more than 70 drugs have been reported to induce oesophageal disorders. Antibacterials such as doxycycline, tetracycline and clindamycin are the offending agents in more than 50% of cases. Other commonly prescribed drugs that cause oesophageal injury include aspirin (acetylsalicylic acid), potassium chloride, ferrous sulfate, quinidine, alprenolol and various steroidal and nonsteroidal anti-inflammatory agents. However, many physicians and even more patients are not aware of this problem.

Capsules or tablets are commonly delayed in their passage through the oesophagus. Highly caustic coatings, direct medication injury and poor oesophageal clearance of pills can lead to acute inflammation. Oesophageal damage occurs when the caustic contents of a drug remain in the oesophagus long enough to produce mucosal lesions. Taking medications at bedtime or without fluids is a common cause of oesophagitis.

The possibility of drug-related damage should be suspected in all cases of oesophagitis, chest pain and dysphagia. History and gastrointestinal endoscopy will confirm the diagnosis. Treatment is supportive, although acid reduction is used frequently as an adjunct. This review reflects the current state of knowledge in this field.

Keywords: Alendronic acid, adverse reactions; Antibacterials, adverse reactions; Antihypercalcaemics, adverse reactions; Nonsteroidal antiinflammatories, adverse reactions; Oesophageal disorders, drug-induced; Potassium chloride, adverse reactions; Quinidine, adverse reactions

Language: English

Document Type: Review article

Affiliations: 1: Department of Gastroenterology, Academic Medical Hospital, Fulda, Germany *

Publication date: 2000-03-01

• In this: publication
• By this: publisher
• In this Subject: Ecology ,  Pharmacology ,  Toxicology
• By this author: Jaspersen D.

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