Pill Esophagitis

Abstract

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.