Is It Drug-Induced Esophagitis? Your Symptoms - Gastroenterology and Hepatology

Q: Is It Drug-Induced Esophagitis? Your Symptoms

Hello： Some medications, such as antibiotics and pain relievers, may cause drug-induced esophagitis and esophageal ulcers. <br>To prevent drug-induced esophagitis, it is recommended to drink plenty of water when taking medications and to avoid lying down immediately afterward. <b

Is it a symptom of esophageal and gastroesophageal reflux disease (GERD)?

Dear Dr.
Lin,
I am a regular office worker.
I started experiencing cold symptoms on June 9 and have been seeing a doctor since then.
The clinic diagnosed me with acute upper respiratory tract infection and acute tonsillitis.
Over a month has passed, and my throat has not improved, and I have developed post-inflammatory hyperpigmentation on my hands.
I am currently following the medication regimen prescribed by my doctor (oral medication for the skin to be taken after breakfast and dinner, and throat medication to be taken after each meal).

On the morning of July 26, I noticed pain from my throat to my chest when drinking water.
I can feel a sharp pain as the water flows down, and there is a sensation of air trapped in my throat when I burp.
Swallowing saliva causes slight pain in the throat area, and there has been no improvement so far.
I would like to ask the doctor if this could be medication-induced esophagitis and whether I should discontinue the medication.

Ping An Jian Kang, 30~39 year old female. Ask Date: 2021/07/28

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: Some medications, such as antibiotics and pain relievers, may cause drug-induced esophagitis and esophageal ulcers.
To prevent drug-induced esophagitis, it is recommended to drink plenty of water when taking medications and to avoid lying down immediately afterward.
For concerns about gastroesophageal reflux disease (GERD), it is advisable to limit the intake of irritant foods such as coffee, chocolate, carbonated beverages, spicy foods, and fried items.
Additionally, pay attention to eating habits and avoid swallowing food hastily.
If you experience throat pain, chest pain, or belching after swallowing saliva, it is recommended to undergo an endoscopy to check for esophageal ulcers, GERD, or other issues.
Wishing you safety and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/28

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your symptoms and the possibility of drug-induced esophagitis. Based on the information you've provided, it does seem plausible that you may be experiencing symptoms consistent with drug-induced esophagitis, particularly given your recent history of medication use for acute upper respiratory infections and tonsillitis.

Understanding Drug-Induced Esophagitis:
Drug-induced esophagitis occurs when certain medications irritate the esophagus, leading to inflammation. This can happen if medications are taken without enough water, if they are taken while lying down, or if they are particularly irritating to the esophageal lining. Common symptoms include difficulty swallowing, chest pain, a sensation of food being stuck in the throat or chest, and pain when swallowing.

In your case, the symptoms you describe—pain from the throat to the chest, a sensation of water causing pain, and discomfort when swallowing—are indicative of esophageal irritation. The fact that these symptoms began after starting your medication regimen raises the suspicion that they could be related to the medications you are taking.

Should You Stop the Medication?
It is crucial to consult your prescribing physician before making any changes to your medication regimen. Stopping medication abruptly can lead to a worsening of your underlying condition. Your doctor may recommend a temporary cessation of the specific medication that you suspect is causing the issue, or they may suggest alternative treatments that are less likely to irritate the esophagus.
In the meantime, here are some general recommendations that may help alleviate your symptoms:
1. Stay Upright After Taking Medications: Always take your medications while sitting or standing, and remain upright for at least 30 minutes afterward to help prevent irritation.

2. Take Medications with Plenty of Water: Ensure you are drinking a full glass of water with your medications to help wash them down and minimize contact with the esophagus.

3. Avoid Irritating Foods: Spicy, acidic, or very hot foods can exacerbate esophageal irritation. Stick to bland, soft foods until your symptoms improve.

4. Consider a Mucosal Protectant: If your doctor agrees, they may prescribe a mucosal protectant to help soothe the esophagus.

When to Seek Medical Attention:
If your symptoms worsen or if you experience severe pain, difficulty swallowing, or any signs of bleeding (such as blood in your saliva or stool), seek medical attention immediately. These could be signs of a more serious condition that requires prompt intervention.

Conclusion:
In summary, while your symptoms are suggestive of drug-induced esophagitis, it is essential to consult your healthcare provider for a definitive diagnosis and appropriate management. They can assess your situation, consider your entire medication regimen, and determine the best course of action to alleviate your symptoms while ensuring your underlying conditions are adequately treated.

Take care, and I hope you find relief soon.

Best regards,
Doctor Q&A Teams

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