Esophageal Burns from Capsule Ingestion: What to Do Next?

Capsule lodged in the esophagus causing burns?

Hello doctor, two days ago I took an antibiotic (capsule form) before bed, and it got stuck when I swallowed it.
I drank some water afterward and went straight to bed.
The next morning, I woke up with a heavy and painful feeling in my chest, and I experienced discomfort while breathing and eating.
I visited a small clinic, and they said I had esophageal burns.
They prescribed me medication for stomach acid, but after two days, the situation hasn't improved...
Should I continue taking the medication for a few more days, or should I go directly to a larger hospital for an endoscopy? P.S.
I noticed that when I touch the right side of my chest (near the esophagus) while showering at night, it hurts.
Is this also related to the burns, or should I have my breast examined separately?

Amei, 10~19 year old female. Ask Date: 2016/03/02

Dr. Lin Minghui reply Gastroenterology and Hepatology

Certain antibiotic capsules, when taken with insufficient water and followed by lying down immediately, can cause esophageal burns or even perforation.
Symptoms include discomfort in the chest and pain while eating.
If there is uncertainty about whether the antibiotic capsule was swallowed, an endoscopy can be performed to confirm the diagnosis and to check for other structural abnormalities, such as gastroesophageal reflux or strictures.
Wishing you good health.

Reply Date: 2016/03/02

More Info

Esophageal burns from capsule ingestion can be a serious concern, especially if the capsule gets lodged in the esophagus. When a capsule is not swallowed properly, it can cause irritation or burns to the esophageal lining, leading to symptoms such as chest pain, difficulty swallowing, and discomfort when eating or breathing. In your case, it sounds like you experienced these symptoms after swallowing an antibiotic capsule and then lying down shortly afterward, which can exacerbate the risk of esophageal irritation.

First and foremost, it is essential to follow up with a healthcare professional if your symptoms persist. While the medication prescribed for acid reduction may help alleviate some discomfort, it is crucial to monitor your symptoms closely. If you continue to experience significant pain or discomfort, or if you develop new symptoms such as difficulty swallowing, persistent chest pain, or any signs of bleeding (like coughing up blood), you should seek immediate medical attention.

In terms of the timeline for recovery, esophageal burns can take time to heal, and the duration can vary depending on the severity of the injury. If you are still experiencing pain after a couple of days of treatment, it may be prudent to consider further evaluation, such as an endoscopy (esophagogastroduodenoscopy or EGD). This procedure allows a doctor to visualize the esophagus directly and assess the extent of any damage. It can also help rule out other potential issues, such as strictures or other complications.

Regarding the pain you are feeling near your right chest wall, it is possible that this discomfort is related to the esophageal irritation. The esophagus runs close to the chest wall, and inflammation or irritation can sometimes cause referred pain in that area. However, if the pain is severe or if you have any concerns about your breast health, it would be wise to consult with a healthcare provider who can perform a thorough examination and determine if further imaging or evaluation is necessary.

In summary, while it is reasonable to continue taking the prescribed medication for a few days, you should remain vigilant about your symptoms. If there is no improvement or if your condition worsens, do not hesitate to seek further medical evaluation, potentially including an endoscopy. Your health and safety are paramount, and timely intervention can help prevent complications from esophageal burns. Always communicate openly with your healthcare provider about your symptoms and concerns, as they can provide the best guidance tailored to your specific situation.

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