To minimize pill-induced esophagitis, a patient should:

• A. Take with a full glass of water and remain upright for at least 30 minutes
• B. Take pills with a small sip of water
• C. Take pills right before lying down
• D. Take pills only at night

Answer: (A)

Preventing pill-induced esophagitis relies on moving the pill quickly through the esophagus and keeping it from lingering on the mucosa. Swallowing with a full glass of water helps wash the pill down and provides lubrication, while staying upright for at least 30 minutes uses gravity to promote esophageal clearance and reduces the chance of the pill sticking to the lining or refluxing. A small sip of water often isn’t enough to ensure the pill clears safely. Lying down soon after swallowing slows esophageal transit and increases mucosal contact time, raising the risk of irritation. Taking pills at night can have the same issue, since you may end up lying down soon after taking them. Therefore, the recommended approach is to take pills with a full glass of water and remain upright for at least 30 minutes.