esophagitis: two case reports
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A.Catinean1, R.Chira1, P.A.Mircea1
1) 1st Medical Clinic. 2)Department
of Pathology, University of Medicine and Pharmacy “Iuliu
Pill esophagitis is a rare
clinical diagnosis. We report a series of two patients who experienced
ulcerative esophagitis while taking doxycycline (patient 1)
and alendronate (patient 2). Both patients presented with retrosternal
pain, odynophagia and dysphagia. Symptoms developed after 3
days of treatment with doxycycline in patient 1 and after 3
months of treatment with alendronate in patient 2. Endoscopy
revealed ulcerative lesions in the mid-esophagus, sparing the
distal esophagus. Biopsies showed inflammatory infiltrate (patient
1) and ulceration and hyperplastic cells (patient 2). Patient
1 recovered completely endoscopically after discontinuation
of the antibiotic and a one month course of sucralfate treatment.
Patient 2 did not accept the discontinuation of alendronate
therapy. She also had a course of one month treatment with sucralfate.
At one, two and even at seven months after the first diagnosis,
endoscopy still showed the persistence of millimetric defects
of epithelisation. She is still under endoscopical survey.
In conclusion, doxycycline
and alendronate can cause chemical esophagitis when taken improperly.
In adults and elderly patients exclusion of esophageal carcinoma
by histology is neccessary. Continuation of treatment with the
offending drug can delay healing. Pill esophagitis is a preventable
cause of morbidity that consists of giving simple advice of
how and when to take medication.
Pill esophagitis –
doxycycline - alendronate