Why are pills hard to swallow?
Many Americans take several pills each day, and approximately half report having difficulties swallowing them. One reason is that pills are designed to transport active drug ingredients into the body and are not specifically manufactured for ease of swallowing. The size, shape, and texture of pills can contribute to swallowing difficulties. Hard and soft gelatin capsules, oval pills, and oblong-shaped tablets are more likely than round pills or irregularly shaped tablets to cause swallowing difficulties.
What causes pill esophagitis?
While the esophagus is often thought of as a rigid tube that helps food pass from the mouth into the stomach, it is actually a muscular structure that stretches to accommodate food, fluids, and medications. Sometimes, the esophagus is unable to stretch enough to allow pills to pass through. When this happens, pills can get stuck in the esophagus and cause tissue damage. Pill esophagitis is a condition caused by medications that lodge in the esophagus, dissolve there, and cause ulcers, inflammation, and other damage to the esophageal tissue.
Who is at risk for pill esophagitis?
Women are more likely than men to develop pill esophagitis, and the condition can affect people of any age. Older people and people who use antihistamine medications (including Benadryl®) can have decreased saliva production or a dry mouth. The lack of saliva can slow the passage of pills through the esophagus and increase the risk of pill esophagitis.
What medications cause pill esophagitis?
Tetracycline antibiotics (including doxycycline), large-sized pills, and gelatin capsules are common causes of pill esophagitis. Doxycycline, iron supplements, and vitamin C pills create acidic solutions when dissolved in water or saliva. The antiseizure medication phenytoin (Dilantin®) produces alkaline fluid when mixed with water. The acidic or alkaline fluid can cause tissue damage and burns when these pills become stuck in the esophagus. The type of pill can also contribute to the development of pill esophagitis, and capsules are three times more likely than tablets to get stuck in the esophagus. Sustained-release formulations are more likely to cause pill esophagitis than immediate-release formulations since the slow release of pill contents allows for continued damage to the esophageal tissue.
What are symptoms of pill esophagitis?
Painful swallowing, which often occurs suddenly, is a common symptom of pill esophagitis. Affected people can also experience chest pain, back pain, and discomfort or difficulty swallowing solids or liquids. Gastrointestinal bleeding, manifested as bloody stools or vomit, can indicate a more serious condition, such as a pill penetrating through a blood vessel.
What is the treatment for pill-induced esophagitis?
The main treatment for pill esophagitis is to stop using the pills that cause the condition. In some cases, pain relievers, H2 blockers (such as famotidine), or other antiulcer medications can be prescribed to treat pill esophagitis. Avoidance of acidic or irritating foods (such as citrus fruits and alcohol) will help alleviate the symptoms of esophageal ulcerations related to pill use.
How long does pill induced esophagitis last?
Typically, pill esophagitis resolves within days to weeks, as long as the medications responsible for the condition are discontinued. Some people with severe pill esophagitis can require surgical treatment of ulcers, bleeding, or scar tissue.
How do you prevent pill esophagitis?
To prevent pill esophagitis, you should take all medications while in an upright position. Pills should be swallowed with 4–8 ounces of water, and you should remain upright for at least 10 minutes after taking medications. People with underlying esophageal disease, such as diverticulosis or dysmotility disorders, should consider the use of liquid medication formulations or crushed pills instead of standard tablets and capsules.
What happens if someone develops pain after taking a pill?
For questions about adverse or unexpected symptoms after taking medications, contact Poison Control for expert advice. There are two ways to contact Poison Control in the United States: online at www.poison.org or by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.
Kelly Johnson-Arbor, MD
Medical Toxicologist
For media inquiries, please contact Krista Osterthaler atosterthaler@poison.org.
Prevention Tips
- Talk to your doctor if you have difficulty swallowing medications.
- Take all solid medications, including tablets and capsules, with a small amount of water to aid in swallowing.
- Avoid sleeping or laying down for at least 10 minutes after taking medication.
This Really Happened
A 28-year-old woman was referred to a gastroenterology clinic due to severe chest and back pain and painful, difficult swallowing. She had been taking doxycycline for acne twice daily with a small amount of water before going to bed for a week prior to the development of her symptoms. When the gastroenterology physicians inserted a small camera into her esophagus, they saw multiple ulcers and inflammation. She was diagnosed with pill esophagitis related to doxycycline use. She was advised to stop taking doxycycline, eat a liquid diet, and take the medications she was given to help heal the esophageal ulcers. She followed these recommendations, and her symptoms resolved completely within 4 days. One month later, a gastrointestinal examination showed full healing of the esophageal ulcers (from Kilincalp & Yusael, 2021).
FAQs
Drug or pill-induced esophagitis is esophageal mucosal injury caused by the medications and usually refers to a direct toxic effect on esophageal mucosa by the culprit medication. Common symptoms include retrosternal pain, dysphagia, or odynophagia.
What is pill esophagitis? ›
Pill esophagitis occurs when capsules or tablets get stuck in the esophagus (food pipe) and cause tissue damage. Antibiotics, including doxycycline, and gelatin capsules are common causes of pill esophagitis. This condition is often painful, but typically resolves after discontinuation of the offending medication.
How to get rid of pill esophagitis? ›
Pill esophagitis is typically treated by stopping or replacing the offending drug. Antacids like Tums and proton pump inhibitors like Prilosec may be prescribed to relieve symptoms and aid with healing.
How long does esophagitis from a pill last? ›
The good news is that pill esophagitis usually goes away. Most cases get better within a few days after stopping the medication that caused the problem. Rarely, if it becomes a chronic condition, you may require long-term therapy to manage pill esophagitis.
What can I eat with pill induced esophagitis? ›
Esophagitis diet includes soft vegetables and vegetables, dairy products (provided you are not allergic to milk), cereals and crackers. While eating, chewing food completely, having small bites and swallowing slowly will also help with the pain.
How do you treat a pill stuck in your esophagus? ›
A person can help with some back blows if they need it. If the person can breathe but the pill is still in their throat, have them drink a few gulps of water or try to eat a small piece of food to dislodge the pill. Do not leave a pill to dissolve in the throat.
What is the fastest way to cure esophagitis? ›
If lifestyle changes alone aren't enough to help your esophagitis, your doctor may suggest you try medicines that reduce stomach acid. Reducing the reflux gives the esophagus a chance to heal. Over-the-counter medicines include: Antacids, such as Maalox, Mylanta, or Tums.
Does drinking water help esophagitis? ›
The best drinks for esophagitis include water, herbal tea, and plant-based milks. These drinks won't irritate your esophagus and may promote inflammation healing. You should avoid very hot liquids, alcohol, and acidic drinks if you have esophagitis.
Will Tums help pill esophagitis? ›
If lifestyle changes alone aren't enough to help your esophagitis, your doctor may suggest you try medicines that reduce stomach acid. Reducing the reflux gives the esophagus a chance to heal. Over-the-counter medicines include: Antacids, such as Maalox, Mylanta, or Tums.
What is the main cause of esophagitis? ›
Most people get esophagitis from acid reflux, which affects at least 20% of the population. But overuse of common over-the-counter medications, like NSAIDs, is another common cause. Less common causes include autoimmune disease and infections associated with weakened immunity. Sometimes it's a combination of these.
In people with a healthy immune system, esophagitis often goes away on its own. People with a weak immune system may take longer to get better.
What medicine heals esophagitis? ›
Recommended medicines may include: Proton pump inhibitors. Your health care provider will likely first prescribe a proton pump inhibitor, such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) or pantoprazole (Protonix). Steroids.
What does an inflamed esophagus feel like? ›
Difficulty swallowing. Painful swallowing. Swallowed food becoming stuck in the esophagus, also known as food impaction. Chest pain, particularly behind the breastbone, that occurs with eating.
What is the immediate relief for pill induced esophagitis? ›
Topical pain relievers, such as viscous xylocaine administered in moderation, may bring some relief and have been used with success in some reported cases. Patients have also been treated with anti-secretory agents, antacids, Gaviscon, and sucralfate to reduce exposure of the injured mucosa to refluxed acids.
What is the most common cause of pill esophagitis? ›
Antibiotics – Antibiotics account for approximately 50 percent of reported cases of pill esophagitis and the most frequent etiology of pill esophagitis in younger adults.
Is banana good for esophagitis? ›
“Bananas are undeniably a good choice for someone living with acid reflux, as they are a low acid-containing fruit,” says Lena Bakovic, a registered dietitian nutritionist for Top Nutrition Coaching in Palm Beach Gardens, FL. “Bananas generally do not work to increase acid production or worsen symptoms of acid reflux.”
What causes esophageal esophagitis? ›
The esophagus is the muscular tube that delivers food from your mouth to your stomach. Esophagitis can cause painful, difficult swallowing and chest pain. Many different things can cause esophagitis. Some common causes include stomach acids backing up into the esophagus, infection, oral medicines and allergies.
Is esophagitis a serious condition? ›
Esophagitis can have serious consequences that affect your quality of life. If left untreated, esophagitis may develop into a condition called Barrett's esophagus. This may increase your risk for esophageal cancer.
Does esophagitis go away? ›
Esophagitis can usually heal without intervention, but to aid in the recovery, eaters can adopt what's known as an esophageal, or soft food, diet. The goal of this kind of diet is to make eating less painful and to keep food from lingering in the esophagus and causing irritation.
What is pill esophagitis omeprazole? ›
Prescription omeprazole is used to treat damage from GERD in adults and children 1 month of age and older. Prescription omeprazole is used to allow the esophagus to heal and prevent further damage to the esophagus in adults and children 1 year of age and older with GERD.
