Winstead Nathaniel S., Bulat Robert
Section of Gastroenterology & Hepatology, Tulane University Health Sciences Center, 1430 Tulane Avenue, SL35, New Orleans, LA 70112-2699, USA.
Curr Treat Options Gastroenterol. 2004 Feb;7(1):71-76. doi: 10.1007/s11938-004-0027-z.
Pill esophagitis is a preventable cause of morbidity. Simple advice on how and when to take medication could probably prevent most cases of the illness. Avoidance of implicated medications in patients with significant risk factors for developing pill esophagitis could prevent additional cases. When the disease presents despite these preventive measures, the mainstays of treatment are immediate discontinuation of the offending agent and supportive care. If the diagnosis is in question, the principle diagnostic modalities are double-contrast barium esophagogram and esophagogastroduodenoscopy. Medical management of moderate to severe cases includes sucralfate to coat, protect, and promote healing of ulcerated esophageal mucosa, and acid-suppressing therapy if gastroesophageal reflux disease is felt to have played a role in the pathogenesis of the illness. Rare cases may require therapeutic endoscopy or surgical intervention early in the disease course. Late complications include esophageal strictures that may require therapeutic endoscopy or bougienage.
药丸性食管炎是一种可预防的发病原因。关于如何以及何时服药的简单建议可能可以预防大多数该疾病病例。对于有发生药丸性食管炎重大风险因素的患者，避免使用相关药物可预防更多病例。尽管采取了这些预防措施仍出现该疾病时，主要治疗方法是立即停用致病药物并给予支持性护理。如果诊断存疑，主要的诊断方式是双重对比钡剂食管造影和食管胃十二指肠镜检查。中重度病例的药物治疗包括使用硫糖铝来覆盖、保护并促进溃疡食管黏膜的愈合，如果认为胃食管反流病在该疾病的发病机制中起作用，则进行抑酸治疗。罕见病例可能在病程早期需要治疗性内镜检查或手术干预。晚期并发症包括食管狭窄，可能需要治疗性内镜检查或探条扩张术。
