Three Cases of Tetracyclines Induced Esophageal Ulcer

Tetracyclines이 원인으로 생각되는 약제성 식도궤양 3례

In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-induced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptomas became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.

Tetracyclines복용으로 유발된 것으로 생각되는 약제성 식도궤양 3예를 보고하고 관계문헌의 내용을 고찰하고 비교해 보았다. 갑작스런 흉골하 작열감, 상복부 불쾌감 및 연하통을 호소할 때는 약제에 의한 식도궤양을 생각해보고 더 많은 관심을 가지고 내시경검사를 시행하면 쉽게 진단할 수 있을 것으로 생각되어지나, 병력과 문진으로도 대개 진단할 수 있다. 또한, 식도궤양을 유발할 수 있는 약물의 capsule이나 정제를 투약할 때는 복용방법과 시각에서, 약이 씻겨 내려갈 정도의 충분한 양의 액체를 같이 복용하도록 하고 잠자리 들기 바로전의 시각은 피하여 복용한 후 약이 내려갈 정도의 충분한 시간동안 눕지 않도록 권유하면 쉽게 예방할 수 있을 것으로 생각된다.