Sevelamer-Induced Esophagitis: A Rare Cause of Severe Gastrointestinal Injury

Sevelamer is a noncalcium-containing phosphate binding medication recommended in guidelines for treatment of hyperphosphatemia in kidney disease. Common gastrointestinal side-effects include abdominal pain, dyspepsia, and vomiting, but gastrointestinal bleeding is not a recognized side effect of sevelamer. The first reported case of sevelamer-induced gastrointestinal injury was in 2013, and since then, very few cases have been described in the literature and the majority of those cases describe lower gastrointestinal bleeding. We report a case of hemodynamically significant sevelamer-induced bleeding from severe esophagitis confirmed with biopsy.