[Importance of drug-induced ulceration in endoscopic lesions of the esophagus].

Drug-induced ulcers of the oesophagus represent a rare but probably under-recorded complication. In a series of 5900 endoscopies performed in 32 months, oesophageal ulcers were seen in 4 cases following the intake of doxycycline, and in one case after ingestion of pinaverium bromide and a bulk laxative respectively. Oesophageal ulcers were seen mainly in young patients without underlying oesophageal disease, presenting with chest pain and odynophagia. The most common site of involvement was at the aortic notch in the middle third of the oesophagus. The course was quickly favorable within 5-10 days after the drug was discontinued, but transient complete abstention from oral intake was required in some cases. Ulceration is thought to be secondary to drug stasis and local cytotoxic effects. Oesophageal ulcers can be prevented simply by recommending intake of the drug with sufficient water in the upright position at least two hours before retiring.