Oral contraceptive pill-induced esophagitis: a rare cause of pill esophagitis in a Rwandan woman

We describe a case of oral contraceptive pill (OCP)-induced esophagitis in a 43-year-old Rwandan woman. She presented with epigastric and retrosternal pain and reported daily use of a combined OCP containing ethinyl estradiol and levonorgestrel. Upper endoscopy revealed a solitary, clean-based esophageal ulcer. Histopathologic evaluation excluded infectious causes, and she improved with proton pump inhibitor therapy and modification of pill consumption habits. This is the first reported case of OCP-induced esophagitis on the African continent and the fifth case overall, and it highlights the importance of awareness of this rare gastrointestinal adverse effect of a commonly used class of drugs, particularly in an area of the world that is promoting the increased uptake of female contraception as a tool for family planning.