Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10994
Revised: April 30, 2014
Accepted: May 25, 2014
Published online: August 21, 2014
Processing time: 157 Days and 1 Hours
AIM: To investigate clinical, endoscopic and pathological characteristics of drug-induced esophagitis.
METHODS: Data for patients diagnosed with drug-induced esophagitis from April 2002 to May 2013 was reviewed. Patients diagnosed with malignancy, viral or fungal esophagitis were excluded. Clinical, endoscopic and pathological characteristics of patients diagnosed with drug-induced esophagitis were analyzed.
RESULTS: Seventy-eight patients were diagnosed with drug-induced esophagitis. Their mean age was 43.9 ± 18.9 years and 35.9% were male. Common symptoms were chest pain (71.8%), odynophagia (38.5%) and dysphagia (29.5%). The endoscopic location was in the middle third of esophagus in 78.2%. Endoscopic findings were ulcer (82.1%), erosion (17.9%), ulcer with bleeding (24.4%), coating with drug material (5.1%), impacted pill fragments (3.8%) and stricture (2.6%). Kissing ulcers were observed in 43.6%. The main causative agents were antibiotics and non-steroidal anti-inflammatory drugs. All the patients were treated with proton pump inhibitors (PPIs) or sucralfate, and the causative drugs were discontinued. Nineteen patients with drug-induced esophagitis were followed up with endoscopy and revealed normal findings, scars or healing ulcers.
CONCLUSION: Drug-induced esophagitis mainly presents as chest pain, odynophagia and dysphagia, and may be successfully treated with PPIs and discontinuation of the causative drug. Kissing ulcers were observed in 43.6%.
Core tip: This study investigated the clinical characteristics of drug-induced esophagitis, such as the main symptoms, common endoscopic findings and main causative agents. Uniquely, kissing ulcers were observed in 43.6% of drug-induced esophagitis, which is a higher rate than in the previous reports. This might be helpful in diagnosing this rare disease. To the best of our knowledge, the present study is the first to compare the histopathological features between drug-induced esophagitis group and reflux esophagitis group.