Pill–Induced Esophagitis

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.