Pills and tablets may get stuck in the esophagus where they can cause a chemical esophagitis and ulceration. With chronic recurrence scarring and strictures may occur. A number of risk factors may predispose to this medication-induced esophageal injury (MIEI).


Risk factors for medication-induced esophageal injury:

(1) abnormal esophageal transit

(2) reclining while taking or immediately after taking the medication

(3) anhydrous formulation that adheres to the moist mucosal surface

(4) taking oral medications with no or little fluid

(5) taking a large number of oral medications

(6) dehydration

(7) formulation that is caustic (either acidic or alkaline)

(8) large tablets or capsule of low density


Abnormal esophageal transit may occur with:

(1) esophageal tumor

(2) stricture

(3) Schatzki's ring

(4) hiatal hernia

(5) extrinsic compression

(6) esophagitis

(7) achalasia


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