Esophageal Ulcereation Induced by Doxycycline

We have observed esophageal ulceration in 15 patients who have been taking doxycycline (Vibromycin) for URI and GU infections. The most usual symptom was retrosternal pain, burning sensation and odynophagia, which sometimes referred to their back and shoulder Symptoms usually occured 5-10 days after their treatment. Endoscopy revealed shallow ulcerations in middle third of esophagus, biopsy showed superficial ulcerations without evidence of specific inflamation and no inclusion bodies seen. We treated our patients with soft diet, Cimetidin antacid and xylocain viscous before meal for odynophagia. All of our patients responded well within one week, and subsequent endoscopies were normal. We are not able to conclude any specific cause for doxycycline induce esophageal ulceration, however it is shown that doxycycline capsule is opened in midle third of esophagus and because of low pH, irritate the mucosa and causes ulceration.