Habib Ahmed Jadoon, Abdul Karim Saeed.
Esophageal ulceration secondary to doxycycline capsules.
J Coll Physicians Surg Pak Jan ;12(11):709-10.

A series of 18 case reports from 1996 to 2002 of oesophageal injury secondary to doxycycline capsules is presented with discussion on presentation, mechanism of injury and its management. Patients presented with sudden onset of retrosternal chest pain and odynophagia which developed within a few hours of ingestion of doxycycline capsules taken with very little fluid at bedtime. Oesophageal ulceration and oesophagitis were the underlying lesions on upper GI endoscopy, which healed within 2 weeks without any long-term complications. In all cases no special dosage instructions were given by the prescribing physicians to prevent this complication.

A 28-year-old woman presented with sudden onset of severe retrosternal chest pain which woke her up at three o`clock in the morning, She reported intense aggravation of pain on swallowing of liquids and solids. She had no past history of similar complaints. She had taken a doxycycline capsule the night before while in bed with a small sip of water. She denied taking any other medication known to cause oesophageal injury. Upper GI endoscopy was performed which showed a small superficial ulcer with well circumscribed margins at 26 cm from incisors. She was started on Omeprazole 20 mg b.i.d orally, Sucralfate suspension and Alginate antacid six hourly and IV fluids. She was kept NPO nil by mouth for two days after which she was gradually put back on normal diet. Symptoms improved in four days and she was discharged on antacids for one week and omeprazole for four weeks. Repeat endoscopy after 4 weeks showed complete resolution of the ulcer. There was no stricture formation.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com