Search

Dysphagia in human immunodeficiency virus (HIV) patients is most commonly of infectious etiology; however, less common causes of esophageal injury, such as strictures and medication-induced injuries, should be considered in the differential process. We report a case of a 53-year-old man with a 6-year history of HIV on highly active antiretroviral therapy and minocycline, who presented to the emergency room with abrupt onset dysphagia to solids and liquids. He was found to have pill impaction requiring mechanical disimpaction related to an esophageal web and pseudodiverticulosis. In this case description we would like to highlight the importance of noninfectious causes of dysphagia in HIV patients.

Dysphagia, or difficulty in swallowing tablets, may greatly affect compliance. This report presents the results of our survey, which was undertaken to determine the proportion of a general practitioner's patient population who had difficulty in swallowing tablets, and to identify the reasons for the difficulty. 6,158 questionnaires were received from patients who consulted a general practitioner. More than 1/4 (26%) of the total patient population (or 1,576) said they had problems in swallowing tablets. A prominent complaint was the size of the tablet, followed by the surface, form and taste of the tablet. Twice as many women as men experienced swallowing problems. Elderly patients (> 70 years) had less difficulty than younger patients when taking tablets. To achieve good compliance and optimal pharmacotherapy, it is important for medical practitioners and pharmaceutical personnel to be aware of the general problems connected to swallowing tablets, to enable them to select the correctly formulated drug for their patients. New and novel oral drug formulations, such as tablets that dissolve in seconds on the tongue without water, may alleviate the problem of swallowing tablets. They offer substantial advantages over ordinary tablets, are more convenient to administer, and enhance the potential for improved compliance in patients who experience difficulty in taking tablets.