2024 Volume 38 Issue 5 Pages 694-698
Objective: To report two cases of dabigatran-induced esophagitis (DIE), which was detected during upper gastrointestinal endoscopy (EGD) as part of a comprehensive medical checkup.
Methods: Two cases of DIE were detected during EGD performed as part of a comprehensive medical checkup at our hospital.
Results: Case 1: The patient, a 76-year-old man, had been taking oral dabigatran since the age of 68 years for atrial fibrillation. He had been aware of a small blockage in his esophagus since then. EGD performed at the time of his current medical checkup revealed white moss deposits on the esophagus. During his checkup interview, he was given instructions on how to take oral medication. Case 2: The patient was an 82-year-old man who had been taking dabigatran since the age of 72 years owing to atrial fibrillation (since the age of 63 years). He did not complain about esophageal symptoms; however, EGD revealed white moss deposits on the esophagus. Hence, he contacted his primary care physician, who changed his medication. At the next EGD, his esophageal findings had improved.
Conclusions: Dabigatran is an anticoagulant that has been commonly used in recent years; however, there have been many reports of esophageal lesions associated with it. Previously, the tartaric acid contained in the drug was thought to be the main cause of esophagitis. Nonetheless, dabigatran itself is likely cytotoxic, and the findings may change depending on the oral administration method at that time, so the disease is suspected. In such cases, detailed interviews and guidance, consideration of changing medications, and close collaboration with clinicians are necessary.
