Dağ Muhammed Sait, Öztürk Zeynel Abidin, Akın Irem, Tutar Ediz, Çıkman Öztekin, Gülşen Murat Taner
Department of Gastroenterology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
Turk J Gastroenterol. 2014 Apr;25(2):180-4. doi: 10.5152/tjg.2014.5415.
BACKGROUNDS/AIMS: Drugs can cause several complications in the esophagus and lead to pill esophagitis. In this paper, our purpose is to share our clinical experience in light of the literature and put forward the general characteristics of pill esophagitis.
In our clinic, between January 2008 and June 2012, by excluding other factors, 48 patients were included in the study, diagnosed as drug-induced esophagitis with their history, endoscopic view, and histopathologic evaluation.
There were 34 (70.9%) female and 14 (29.1%) male patients in the study, and their average ages were 35.1 and 32.4, respectively. Clinical symptoms were odynophagia (79.1%), retrosternal pain (62.5%), and dysphagia (47.9%). The reason for these symptoms for 85.5% of the patients was related to insufficient water consumption while taking the pill, taking the pill in recumbent position, or both. Tetracycline and its variant, doxycycline, were responsible for 52% of the patients, and 62.5% of the drugs were in capsule form. Ulcers were at the proximal and middle third of the esophagus in 79.2% of the patients. In the histopathologic evaluation, nonspecific acute inflammatory changes were found in 29.1% of the cases. Various proton pump inhibitors and sucralfate were used in the treatment. While no perforation and structure were detected, 1 patient died because of repetitive arterial bleeding.
Almost every kind of drug, particularly doxycycline, can cause ulcer in the esophagus. Pill esophagitis can be prevented by warning patients about drinking water sufficiently and sitting up while taking the pill.
背景/目的：药物可在食管引发多种并发症并导致药源性食管炎。本文旨在结合文献分享我们的临床经验，并提出药源性食管炎的一般特征。
在我们的诊所，2008年1月至2012年6月期间，排除其他因素后，48例患者纳入研究，根据病史、内镜检查及组织病理学评估诊断为药物性食管炎。
研究中有34例（70.9%）女性患者和14例（29.1%）男性患者，平均年龄分别为35.1岁和32.4岁。临床症状为吞咽痛（79.1%）、胸骨后疼痛（62.5%）和吞咽困难（47.9%）。85.5%的患者出现这些症状的原因与服药时饮水不足、卧位服药或两者皆有有关。四环素及其变体强力霉素导致了52%的病例，62.5%的药物为胶囊剂型。79.2%的患者溃疡位于食管近端和中段三分之一处。组织病理学评估中，29.1%的病例发现非特异性急性炎症改变。治疗中使用了各种质子泵抑制剂和硫糖铝。虽未检测到穿孔和狭窄，但有1例患者因反复动脉出血死亡。
几乎每种药物，尤其是强力霉素，都可导致食管溃疡。通过告知患者服药时充分饮水并坐立，可预防药源性食管炎。
