Swallowing meds.

[3660]

Hi there . My husband died nearly 3 years ago, age 72, with cancer of the lower part of the oesophagus. He had a terrible habit of swallowing medication in tablet form with either no fluids or hot tea.( He would be taking something like 10 tablets over each day, plus pain killers with no coating.) I know neither is good but would this habit have done harm to his oesophagus. I suppose the answer is it wouldn't be doing it much good. Many thanks for any comment.

[Debbiewallis]

Hi

I’m so sorry to hear that! You don’t mention why he was taking all the tablets ? was it a problem with reflux or some other medical problem? Why I mention it is if it was the latter did he never get it checked out ? My husband has recently had an Ivor Lewis procedure for Ca Oesophagus and not long after I realised I was having pains and was found to have Barrett’s Oesophagus ! so now I will get 3 yearly surveillance although I must admit I’m really twitchy when I think the tablets aren’t working!

Deb

[3660 in reply to Debbiewallis]

Hi Deb Thank you for your message, much appreciated. The tablets my husband took were many and varied, some for arthritis and thyroid. I often wondered if because the tablets were melting on the way down they could be burning his oesophagus and without the help of fluids this was making the area inflamed. Being a man he wouldn't take advise!! He always said he'd been doing it that way for years and didn't see the point of changing. I'd only known him 4 years and married for 2 so couldn't argue (but I tried) Thank you again and hope things go good for you and your husband

[Hidden]

Sorry to hear about your husband, and it is natural to wonder whether any of these things might have contributed to the disease. I think it is very unlikely but nobody really knows for sure. If his oesophagus was working normally, and it is very rare in a healthy person for it not to, the swallowing process, called peristalsis, carries pills through to the stomach as part of the natural, progressive contraction of muscles, helped by saliva. When you swallow pills without drinking, you normally do a gulping action that starts them off down your throat. It is true that strong pills can occasionally get stuck and can in rare cases cause some injury to the lining of the oesophagus but I think if it were significant he would have felt it sticking and would have drunk tea or other liquid to have washed it down. It would have been painful. Some pills are designed, as you say, to keep their coating until they reach the stomach, where they dissolve.

70% of cases of oesophageal cancer in the UK are adenocarcinoma, that tends to occur at the junction of the oesophagus and the stomach, and there is a strong relationship with reflux (and sometimes obesity, which tends to create upward pressure on the stomach and push the reflux upwards). There is a valve, the lower oesophageal sphincter, by the abdomen that should keep the stomach contents in place, but when this is weak, or it relaxes too much, this can be a contributory factor and can be felt as heartburn. Men are affected much more than women.

The great majority of the other 30% of cases are squamous cell carcinoma, which tends to occur higher up towards the throat, and statistically has much more association with alcohol and smoking, but it is a lot more complex than that.

This cancer tends not to have had its fair share of research over the years. Hopefully we will know many more answers about this dreadful disease in the years to come.