9/11/2023 0 Comments I went back intime to 1970s nyG&H Can patients with pill-induced esophagitis take other oral medications in order to relieve their symptoms? However, this scenario is fairly uncommon. Some cases are complicated by stenosis, hemorrhage, or even perforation. They may require parenteral fluid support or alimentation. In more severe cases, patients may not be able to eat for a period of time. It lasts a few days and gets better gradually. This pain may be continuous and is often exacerbated by swallowing. Two hours later, they develop a rapidly increasing severity of chest pain. JWK The typical patient takes a pill, perhaps without a lot of water, just as they are going to bed. G&H Can you describe the typical symptoms and presentation of a patient with pill-induced esophagitis? This scenario is designed to cause problems, and patients who are already ill do not need any extra problems. This is in contrast to the way pills are often given to sick people, where the patient is in bed, props up on one elbow, takes the pill, and then goes right back to sleep. Patients should be reminded that any pill, particularly the more caustic pills that have been frequently reported to cause this type of injury, should be taken upright, with a full glass of water, and not immediately prior to going to bed. On the other hand, therapies with heavy pill burden, such as mesalamine formulations for inflammatory bowel disease, do not necessarily relate to pill-induced esophagitis because they do not have the same caustic properties. A lot of the antibiotics are inherently injurious if they remain in contact with the mucosa. The contents of certain pills are simply more caustic. The likelihood of injury has more to do with the specific pills that are taken and the posture in which the patient habitually takes them, as well as whether or not they take a significant amount of water with them. The quantity of pills taken has not been correlated with esophagitis. Those who have esophageal motility disorders of any sort seem to be predisposed, although this is not entirely clear in the case reports in the literature. Patients with cardiomegaly with left atrial enlargement seem predisposed to the condition because the left atrium can compress the esophagus. I believe that elderly patients are more likely, given the same medications, to develop pill-induced esophagitis than younger patients. JWK Most patients who develop pill-induced esophagitis are receiving antibiotics for any number of common conditions, including urinary tract infections and strep throat. G&H Is there a particular group of patients who are at high risk for pill-induced esophagitis?
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