You are correct. Dabigatran capsules may cause esophageal lesions, eg, exfoliative esophagitis, due to their strong acidity. Even pts who take dabigatran correctly, w/ sufficient water in an upright position, may develop exfoliative esophagitis. Therefore, physicians should specifically ask about digestive sx if the anticoagulant is prescribed. If dabigatran-induced exfoliative esophagitis is suspected, an alternative anticoagulant should be considered. When asked about GI problems, the pt admitted to occasional slight chest discomfort a few min after taking dabigatran correctly, but he was not concerned. Dabigatran was replaced w/ rivaroxaban while continuing lansoprazole, and the sx disappeared w/in several days. One mo later, endoscopy showed improvement, w/ an almost normal appearance of esophageal mucosa.