Esophageal lesions can result from ingested medication which undergoes slow transient through esophagus with resulting prolonged mucosal contact and caustic damage. Typical agents include potassium chloride, quinidine, ascorbic acid, tetracyclines, NSAIDS, and bisphophonates. It is important that these medications be accompanied with ample water to prevent slow esophageal transit. One study of aspirin sized barium tablets administered to patients undergoing routine upper GI showed that half remained in the esophagus for more than 5 minutes. Bisphosphonates are particularly notorious for causing esophageal irritation.
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