Celecoxib associated esophagitis: review of gastrointestinal side effects from cox-2 inhibitors

BACKGROUND: With the extensive use of COX-2 inhibitors to treat inflammatory and pain syndromes, gastrointestinal adverse effects are being increasingly observed. CASE REPORT: An 87-year-old white man with chronic peptic esophageal stricture presented to us with dysphagia and odynophagia. The patient was taking Celecoxib for 5 months for trigeminal neuralgia. An upper endoscopy revealed severe desquamative esophagitis. Celecoxib was discontinued and the patient was started on esomeprazole. The patient's symptoms improved in 1 month. Three months later, EGD revealed complete healing of the esophageal mucosa. DISCUSSION: Because recent studies have shown that COX-2 inhibitors are similar to NSAIDs with regards to absorption, in contrast to premarketing trials, extensive use of COX-2 inhibitors is likely to demonstrate gastrointestinal adverse effects similar to those caused by traditional NSAIDs. Our patient had severe esophagitis caused by Celecoxib and aggravated by reflux of achlorhydric gastric contents after dilatation of the stricture. SUMMARY: We report for the first time severe esophagitis caused by the COX-2 inhibitor Celecoxib.