Tetracycline Ulcers of the Oesophagus. Endoscopy, Histology and Roentgenology in Two Cases, and Review of the Literature

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Abstract
Two cases of tetracycline ulcers of the esophagus were reported and compared with 13 other cases from the literature. In most cases, the patients had taken their capsules with little or no fluid just before going to bed. Some hours later they developed retrosternal pain that was intensified by swallowing. Endoscopy showed sharply demarcated greyish-white areas of mucosal damage which represented layers of stratified squamous cells, separated by edema, and a dense neutrophilic infiltration of the lamina propria and the muscularis mucosa. Roentgenology was unsuitable to detect the lesions. They healed without complications within 1-6 wk. Prolonged retention of the capsules in the esophagus was thought to cause the mucosal damage. Patients on oral tetracycline or doxycycline treatment should be instructed to take their capsules with a meal or with copious water and not just before going to bed.