Minireviews
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World J Gastroenterol. Apr 28, 2024; 30(16): 2220-2232
Published online Apr 28, 2024. doi: 10.3748/wjg.v30.i16.2220
Drug-induced mucosal alterations observed during esophagogastroduodenoscopy
Masaya Iwamuro, Seiji Kawano, Motoyuki Otsuka
Masaya Iwamuro, Seiji Kawano, Motoyuki Otsuka, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Iwamuro M designed the study and wrote the paper; Iwamuro M and Kawano S collected the data; Kawano S and Otsuka M critically reviewed the manuscript for important intellectual content; and Otsuka M approved the manuscript.
Conflict-of-interest statement: Iwamuro M has received lecture fees from Otsuka Pharmaceutical Co., Ltd. and Ono Pharmaceutical Co., Ltd., as well as grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd. Kawano S has received lecture fees from Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Astellas Pharma Inc., AstraZeneca PLC, Viatris Inc., Zeria Pharmaceutical Co., Ltd., and EA Pharma Co., Ltd., along with grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd. Otsuka M has received lecture fees from Chugai Pharmaceutical Co., Ltd., Gilead Sciences, Inc., Merck & Co., Inc., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, AbbVie GK, EA Pharma Co., Ltd., and Kowa Company, Ltd., along with grants from Taisho Pharmaceutical Co., Ltd., Zeria Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Abbott Japan Co., Ltd.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Masaya Iwamuro, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan. pr145h2k@okayama-u.ac.jp
Received: December 24, 2023
Revised: January 24, 2024
Accepted: April 1, 2024
Published online: April 28, 2024
Processing time: 124 Days and 3.7 Hours
Abstract

Several features of drug-induced mucosal alterations have been observed in the upper gastrointestinal tract, i.e., the esophagus, stomach, and duodenum. These include pill-induced esophagitis, desquamative esophagitis, worsening of gastroesophageal reflux, chemotherapy-induced esophagitis, proton pump inhibitor-induced gastric mucosal changes, medication-induced gastric erosions and ulcers, pseudomelanosis of the stomach, olmesartan-related gastric mucosal inflammation, lanthanum deposition in the stomach, zinc acetate hydrate tablet-induced gastric ulcer, immune-related adverse event gastritis, olmesartan-asso-ciated sprue-like enteropathy, pseudomelanosis of the duodenum, and lanthanum deposition in the duodenum. For endoscopists, acquiring accurate knowledge regarding these diverse drug-induced mucosal alterations is crucial not only for the correct diagnosis of these lesions but also for differential diag-nosis of other conditions. This minireview aims to provide essential information on drug-induced mucosal alterations observed on esophagogastroduodenoscopy, along with representative endoscopic images.

Keywords: Diagnosis; Esophagogastroduodenoscopy; Non-neoplastic lesions; Esophageal lesions; Gastric lesions; Duodenal lesions

Core Tip: Various lesions associated with medication use are detected during esophagogastroduodenoscopy, including pill-induced esophagitis, desquamative esophagitis, deteriorating gastroesophageal reflux, chemotherapy-induced esophagitis, proton pump inhibitor-induced gastric mucosal changes, medication-induced gastric erosions and ulcers, pseudomelanosis of the stomach, olmesartan-related gastric mucosal inflammation, lanthanum deposition in the stomach, zinc acetate hydrate tablet-induced gastric lesions, immune-related adverse event gastritis, olmesartan-associated sprue-like enteropathy, duodenal pseudomelanosis, and lanthanum deposition. Endoscopists must diagnose these mucosal alterations by acquiring pertinent knowledge regarding medication-induced lesions, concomitant with inquiries concerning patient medication history.