Calcium multimineral complex induced esophageal stricture

Pill-induced esophageal injury remains an under-recognized event despite its potentially devastating consequences. Most cases are due to nonsteroidal anti-inflammatory drugs, antibiotics, or bisphosphonates, and symptoms usually resolve upon discontinuation of the medication. Reported herein is the case of an elderly woman who experienced prolonged impaction of a calcium tablet in the upper esophagus. She reported breaking the nonprescription pill in half prior to ingestion due to its large size. Subsequently, a severe esophageal stricture developed. We are unaware of any previous cases of esophageal stricture due to an impacted tablet containing primarily calcium, among other minerals. This is relevant, as patients are being advised by both their physicians and the lay press to increase calcium intake. It also highlights the importance of proper instruction and cautions for taking both prescription and over-the-counter preparations. Management of patients with suspected pill impaction is discussed.