Pill–Induced Esophagitis

by Carlo Raj, MD

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    00:01 Let us now take a look at Pill-Induced Esophagitis.

    00:04 At this point, we’ve completed a discussion of our reflux with GERD and Barrett’s.

    00:12 What kind of pills might you be taking? Well here, when you’re swallowing a pill, focal damage in the mid-esophagus because of the exposure of the pill there more so.

    00:23 Prolonged stasis of certain meds in the esophagus may then cause it.

    00:28 Here, your focus should be on potassium compounds, NSAIDs for sure.

    00:33 In addition, there’s quinidine, iron, maybe a patient is taking alendronate due to osteoporosis, tetracycline, vitamin C; all this could be pill-induced esophagitis.

    00:47 This condition occurs most commonly in the elderly, and there are several factors thought to be involved.

    00:52 These include decreased salivary production, swallowing the pill while in the recumbent position, falling asleep shortly after taking the medication, and insufficient water intake with the pill.

    01:02 Treatment for this condition usually starts with discontinuation the offending medication.

    01:07 Sometimes the medication is one that can’t be stopped, and in those instances, encouraging lifestyle modifications can be helpful.

    01:14 These would include taking the pill with a full glass of water, remaining upright for some period of time after ingesting the pill, and not taking the medication right before bedtime.

    01:22 A short course of a PPI or antacid can also help prevent mucosal irritation from excess acid.

    01:28 Oral sucralfate can be used to help form a protective barrier and avoidance of potentially irritating foods maybe helpful as well.

    About the Lecture

    The lecture Pill–Induced Esophagitis by Carlo Raj, MD is from the course Esophageal Disease.

    Included Quiz Questions

    1. NSAID use
    2. Myocardial ischemia
    3. Peptic ulcer disease
    4. GERD
    5. Infection
    1. Magnesium and atenolol
    2. Iron and vitamin C
    3. Tetracycline and quinidine
    4. Potassium chloride and alendronate
    5. Aspirin and ibuprofen
    1. Drug-induced esophagitis
    2. GERD
    3. Fungal esophagitis
    4. Zenker's diverticulum
    5. NSAIDs

    Author of lecture Pill–Induced Esophagitis

     Carlo Raj, MD

    Carlo Raj, MD

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