Esophagus/Reflux
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →Analysis of Esophageal Ulcers Using the Japanese Adverse Drug Event Report Database.
Clinical takeawayconsider parenteral anticancer drugs (e.g., bevacizumab, paclitaxel) in the differential for esophageal ulcers, especially in patients without typical pill esophagitis risk factors
What it foundSignals detected for 15 oral drugs and 7 parenteral anticancer drugs, with doxycycline and dabigatran etexilate showing median onset times of 8 and 12.5 days for pill-induced esophagitis.
ContextThis literature reports that comprehensive analysis of adverse event databases supports early detection and prevention of drug-induced esophageal ulcers, including potential associations with parenteral drugs.
Refinessuggested applicable standard· American College of Gastroenterology, 'ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease' (Katz PO et al., Am J Gastroenterol 2022;117(1):27-56). DOI 10.14309/ajg.0000000000001538, PMID 34807007. PARTIAL COVER ONLY - see source_verification_note. No society guideline dedicated to medication-induced (pill) esophagitis exists.
Decision at stakeidentifying and managing medication-induced esophageal ulcers
American College of Gastroenterology, 'ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease' (Katz PO et al., Am J Gastroenterol 2022;117(1):27-56). DOI 10.14309/ajg.0000000000001538, PMID 34807007. PARTIAL COVER ONLY - see source_verification_note. No society guideline dedicated to medication-induced (pill) esophagitis exists. · reviewed 2026-07-21 ↗Discontinue or reformulate the offending pill (e.g., doxycycline→alternative antibiotic if clinically appropriate, oral bisphosphonate→IV zoledronate after risk/benefit assessment, extended-release KCl→liquid if needed, ferrous sulfate→liquid or IV iron if malabsorption present) and deliver administration counseling. Treat with PPI BID (or vonoprazan) for 4-8 weeks for symptom relief and healing, considering sucralfate slurry as adjunctive therapy in select cases with severe mucosal injury. Provide teach-back counseling to prevent recurrence. Repeat EGD if symptoms persist, and pursue motility workup for recurrent episodes despite proper administration.
Hayashi T … Shimizu T · Journal of Clinical Gastroenterology · IF 2.9 · PubMed ↗