OBJECTIVE

Summarize and provide information about drugs that could cause esophagitis, describe the features of pathogenesis, clinical symptoms, diagnosis, treatment, and prevention of such esophageal damage.

KEY POINTS

Drug-induced esophageal lesions arise due to the toxic effect of the drugs and their effect on the nervous system. More than 100 drugs that could cause or aggravate the course of esophagitis have been described since the 1970s. Esophageal lesions induced by antibiotics, antiretroviral drugs, antitumor drugs, and non-steroidal anti-inflammatory drugs are best studied. The clinical symptoms of drug-induced esophagitis are diverse and nonspecific: chest pains, heartburn, odynophagia, dysphagia, weight loss, hematemesis. The gold standard for diagnostics is endoscopy, which allows identifying lesions of the esophagus (erosion, bleeding, ulcers) and residual fragments of drugs. Risk factors of drug-induced esophagitis include a supine position during and within 30 minutes after taking the drug, insufficient water when using drugs, the use of large-sized tablet drugs and/or drugs in a gelatin capsule presence of concomitant esophageal pathology. To treat drug-induced esophageal damages are used proton pump inhibitors, analgesics, H2-histamine receptor blockers, sucralfate, besides cancellation of the drug with which its development is associated. As a preventive measure, it is recommended to take the tablets in a sitting or standing position one at a time, drinking plenty of water, and then staying upright for at least 30 minutes.

CONCLUSION

Drug-induced esophageal lesions remain a problem of current interest, as they are accompanied by clinical symptoms that significantly impair patients’ quality of life and could also cause serious complications. Timely diagnosis, treatment, and prevention of drug-induced pathologies of the esophagus are important medical practitioners’ tasks.