Taking a pill prescribed by a physician before going to bed might be normal for many people, but it created a nightmare for a 57-year-old Taichung man who had to have parts of his esophagus removed because of severe ulcerations, prompting one doctor to advise people not to lie down right after swallowing pills or capsules.
Tung Yung-wei (童詠偉), director of the thoracic surgery division at Tung’s Taichung MetroHarbor Hospital, said a man surnamed Chen (陳) ran into trouble after he crashed into a telephone pole and went to the emergency room for treatment.
After his injuries were treated, Chen was prescribed some medication.
“Chen only took a small sip of water to swallow the drugs before going to sleep. He said his throat felt a little strange the next morning, but he did not think much about it until he began having difficulty swallowing and there was neck swelling six days later,” Tung said.
A computerized tomography scan showed gas and ulcers in Chen’s mediastinum, the middle section of the chest cavity, while a gastroscopy found parallel ulcerations in his upper esophagus, Tung said.
Chen underwent emergency surgery to debride the mediastinum and remove damaged parts of his esophagus, the doctor said.
He also had to have a gastrostomy to create an opening in the stomach for nutritional support, Tung said.
Chen had more surgery three months later to reconstruct his esophagus using a section of his colon, Tung said, and he eventually regained his ability to eat normally.
It is not uncommon for people to develop esophageal ulcers if medications get stuck in their throats, but the ulceration and esophageal rupture suffered by Chen is rare, the doctor said.
“It could have been because Chen is a diabetic with poor blood sugar control, which has hurt his immune system and his body’s autogenous healing ability,” Tung said.
People should drink 200ml to 300ml of warm water when injesting capsules or pills that are highly aciditic or alkaline, such as tetracycline, iron supplement pills, anti-inflammatory drugs and painkillers, Tung said.
He also warned against lying down after swallowing medication, saying that it is better to remain seated or standing for 30 minutes.
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