Symptoms of Drug-Induced Esophageal Ulcers: What to Expect?

What are the symptoms of drug-induced esophageal ulcers?

Hello, doctor: Due to other medical conditions, I have been taking antibiotics.
Recently, while working outside, I forgot to bring water, so I bought bottled water from a convenience store to take my evening medication.
However, the water was too cold, and I hurriedly took a couple of sips before swallowing the pill.
That night, I felt no unusual symptoms, but the next morning I noticed a tight sensation in my throat and a feeling of pressure in my chest.
I can swallow saliva and eat normally without pain.
Three days have passed, and the symptoms remain the same.
I can't distinguish whether it's a sore throat or esophagitis.
Should I first see a gastroenterologist or an ENT specialist? Is it true that medication-induced esophageal ulcers cause immediate pain symptoms, or could inflammation develop a few days later?

Yao jiankang, 30~39 year old female. Ask Date: 2017/07/28

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Drug-induced esophageal ulcers typically present with symptoms such as chest pain and odynophagia, often occurring within 1 to 2 days.

Reply Date: 2017/07/28

More Info

Drug-induced esophageal ulcers can present with a variety of symptoms, and understanding these can help you determine the best course of action for your health. When medications, particularly certain antibiotics or non-steroidal anti-inflammatory drugs (NSAIDs), are ingested without adequate water, they can irritate the esophagus, leading to inflammation or ulceration.

Symptoms to Expect
1. Pain or Discomfort: One of the most common symptoms of esophageal ulcers is pain or discomfort in the chest or throat. This can feel like a burning sensation or a tightness, which may be what you are experiencing. The pain can sometimes be mistaken for heartburn or gastroesophageal reflux disease (GERD).

2. Dysphagia: Difficulty swallowing (dysphagia) can occur, although you mentioned that swallowing saliva and food has been normal for you. This symptom can vary depending on the severity of the ulceration.

3. Odynophagia: This refers to pain during swallowing. If the ulcer is significant, you might experience pain when swallowing food or liquids.

4. Nausea and Vomiting: Some patients may experience nausea or even vomiting, particularly if the ulcer is causing significant irritation.

5. Sore Throat: A sore throat can accompany esophageal ulcers, especially if the inflammation extends to the throat area.

6. Chest Pain: This can sometimes mimic cardiac pain, which is why it’s essential to differentiate between the two.

Timing of Symptoms
Regarding your question about the timing of symptoms, drug-induced esophageal ulcers can manifest immediately after ingestion or may take a few days to develop. The initial irritation may not cause immediate pain, but inflammation can progress over time, leading to more noticeable symptoms. Therefore, it is entirely possible that you could experience symptoms a few days after taking the medication, especially if the esophagus was irritated by the cold water and the medication.

Next Steps
Given your symptoms of tightness in the throat and chest discomfort persisting for three days, it would be prudent to consult a healthcare professional. Since your symptoms could be related to either esophageal irritation or throat issues, you might consider starting with a gastroenterologist, as they specialize in the digestive system, including the esophagus. If they determine that your symptoms are more related to throat issues, they may refer you to an otolaryngologist (ear, nose, and throat specialist).

Management and Prevention
1. Hydration: Always take medications with a full glass of water to help ensure that the pill moves down the esophagus properly and to minimize irritation.

2. Medication Review: Discuss with your healthcare provider about the medications you are taking. Some may have a higher risk of causing esophageal irritation, and alternatives may be available.

3. Dietary Adjustments: If you have existing esophageal irritation, consider avoiding spicy, acidic, or very hot foods that may exacerbate your symptoms.

4. Follow-Up: If symptoms persist or worsen, follow up with your healthcare provider for further evaluation, which may include imaging studies or endoscopy to assess the esophagus.

In conclusion, while drug-induced esophageal ulcers can present with a range of symptoms, the timing and severity can vary. It is essential to seek medical advice to ensure proper diagnosis and treatment.

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