Oral medication-induced esophageal injury in elderly patients.
ABSTRACT Although oral medication induced esophageal injury (OMIEI), is a well-known and preventable condition, many cases are still missed, particularly in the elderly patients. OBJECTIVE To determine the frequency and outcome of oral medication-induced esophageal injury in elderly patients. METHODS Records of 390 patients aged over 65 years, with diagnoses of dysphagia, odynophagia, and noncardiac chest pain, over the period of 11 years, were selected for a retrospective review. Patients who had barium studies only, in whom endoscopy was not done or was unsuccessful, and those with incomplete data were excluded, leaving 250 patients for further review. RESULTS Diagnosis of OMIEI was made in 27% (68 of 250) patients. Fifty-one of 68 (75%) patients with OMIEI responded to conservative management, including H2 blockers, proton pump inhibitors, antacids, or sucralfate. The remaining 17 patients (25%) developed esophageal strictures requiring dilation. CONCLUSIONS A high index of clinical suspicion and low threshold for empiric treatment and diagnostic measures (endoscopy, barium swallow study), may be helpful, if indicated, for early diagnosis and prompt therapy of OMIEI.
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000008:administration & dosage / Q000009:adverse effects; D003680:Deglutition Disorders / Q000139:chemically induced; D004724:Endoscopy; D004935:Esophageal Diseases / Q000139:chemically induced*; D004947:Esophagus / Q000187:drug effects*; D005260:Female; D006635:Histamine H2 Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D011522:Protons; D012189:Retrospective Studies; D013392:Sucralfate / Q000008:administration & dosage / Q000009:adverse effects
D000863:Antacids; D006635:Histamine H2 Antagonists; D011522:Protons; D013392:Sucralfate