Clinical and endoscopic characteristics of drug-induced esophagitis

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 antiinflammatory 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%.