Taking medication seems like an easy task, just put the medicine in your mouth and swallow it, nothing special. In fact, the art of taking medication is not as simple as people imagine.
One: Older people are more prone to esophageal injury when taking medication
Medications pass through the esophagus into the stomach from the throat. In fact, every normal person's esophagus has three "physiological narrowings". If the process of taking medication is not scientific, the tablets or capsules may get stuck in the narrow parts of the esophagus. When the medication is dissolved, a high concentration accumulates locally, directly irritating the esophageal mucosa. Prolonged and repeated irritation can easily cause esophagitis, and even ulcers and erosion, leading to drug-induced esophagitis.
For older people, they often have chronic diseases and need to take medication more frequently. Slow gastrointestinal motility and reduced salivary gland secretion result in poor lubrication of the esophagus, making tablets, pills, capsules, etc. more likely to stick. If symptoms such as foreign body sensation in the throat, heartburn, and pain behind the sternum occur after taking medication, it may be drug-induced esophageal injury. Stopping the use of relevant medications usually leads to relief of symptoms within 7 to 10 days. If there is no improvement or if the symptoms are severe, it is necessary to go to the hospital for examination.
Two: Commonly used highly irritant medications:
Antibiotics: erythromycin, azithromycin, amoxicillin, ampicillin, clindamycin, metronidazole, ciprofloxacin, etc.
Antipyretic analgesics: aspirin, ibuprofen, diclofenac, paracetamol, dexamethasone, etc.
Other medications: potassium chloride, aminophylline, vitamin C, ferrous sulfate, Liu Shen Wan, throat tablets, Qi Zhen Dan, etc.
Three: Beware of factors that affect esophageal health
1. Improper way of taking medication
Under normal circumstances, medications pass through the esophagus from the oral cavity and quickly reach the stomach, rarely causing adverse reactions in the esophagus. However, incorrect ways of taking medication, such as dry swallowing tablets, not drinking enough water, taking medication while lying down, or immediately going to bed after taking medication, can be "harmful" to the esophagus. Studies have shown that when taking medication while drinking water in an upright position, the medication reaches the stomach through the esophagus within 15 seconds; while without drinking water or drinking water and then lying down, after 10 minutes, about 50% of the medication has not entered the stomach.
2. Large and hard tablets
Some tablets are large and hard, and if they get stuck in the narrow parts of the esophagus during medication, they can cause injury. Capsules made of gelatin will expand when in contact with a small amount of water, making them more likely to be retained than tablets.
3. Highly irritant medications
Some medications are alkaline or acidic, and if they stay in the esophagus for too long, they directly irritate the mucosa, causing chemical damage. Antitumor medications are highly toxic, especially drugs with significant cytotoxicity, which can directly damage the esophagus. Antibiotics are also highly irritant.
4. Abnormalities in the esophagus itself
For example, in patients with heart disease, an enlarged heart can compress the esophagus. In addition, esophageal narrowing, slow peristalsis, and gastroesophageal reflux are all unfavorable for medication passage.
Four: Remember these four prevention principles
Paying attention to some "details" during daily medication can help avoid or reduce damage to the esophagus.
1. Before taking medication, drink some warm water to lubricate the esophagus and facilitate the passage of tablets and capsules. If the patient does not need to restrict water intake, the amount of water taken with each dose should not be less than 100 milliliters. Especially when taking highly irritant medications, remember to drink plenty of water.
2. When taking medication, try to maintain an upright position, and patients who are bedridden should sit up. Especially for the elderly and those with structural and functional abnormalities of the esophagus, it is advisable to take medication while sitting or standing, and do not lie flat immediately after taking medication, at least maintain a standing or sitting position for a few minutes.
3. For irritant medications that are not affected by food intake, they can be taken after meals.
4. Many elderly people have difficulty swallowing and are afraid of the impact of medications on the esophagus, so they crush the medicines or remove the outer shell of capsules before taking them. This practice must be approved by a doctor, because some tablets and capsules have enteric coating or sustained-release effects and cannot be arbitrarily destroyed.
