Complete Recovery from Iron-Induced Esophageal Ulcer While Continuing Pill Ingestion

Iron is one of the common causes of pill-induced esophagitis with a proposed mechanism involving direct esophageal injury. Diagnostic endoscopic finding includes finding an intact pill or its residue on endoscopy, but they are rarely found. Pathology typically reveals luminal brown-black crystalline materials adjacent to the injured surface epithelium or in combination with luminal fibroinflammatory exudate. Brown crystalline material on Perl’s staining is the typical finding of iron-induced esophagitis. Crucial treatment is cessation of medication. We report an elderly woman diagnosed with iron-induced esophageal ulcer whose ulcers improved while iron medication was maintained.