Semaglutide and Gastroparesis: What We Know

Semaglutdie-containing medications (like Ozempic, Wegovy, Rybelsus) have recently made headlines after some reports of gastroparesis. And experts don't know for sure if this side effect is linked to semaglutide itself. 

Keep in mind that several other medications and health conditions can cause gastroparesis. There were no reports of gastroparesis in a 2-year clinical study of semaglutide use in patients with overweight or obesity.

And while semaglutide and other GLP-1 agonists like tirzepatide (Mounjaro, Zepbound) and liraglutide (Victoza, Sexenda) cause stomach-related side effects like nausea, vomiting, upset stomach, diarrhea, and constipation, we know these effects happen because the medications slow down how quickly food leaves your stomach (delayed gastric emptying). 

The good news is that these side effects are reported to be reduced after about 5 months (20 weeks) of use.

In this podcast, we'll discuss gastroparesis, what causes gastroparesis, and how to lower your risk of gastroparesis.

What is Gastroparesis?

Gastroparesis occurs when the stomach muscles fail to function properly, leading to slowed or incomplete movement of food and liquid from the stomach to the small intestine, even though there isn't a blockage. 

This delay can result in digestive issues and discomfort for individuals with gastroparesis. Symptoms include stomach pain, ulcers, and heartburn. You may also experience nausea and vomiting.

What Causes Gastroparesis?

One of the most common causes of gastroparesis is diabetes (T1DM or T2DM). High blood sugar levels over time can damage the vagus nerve, which controls the stomach muscles.

Some individuals may develop gastroparesis as a complication of abdominal surgery, particularly those involving the stomach or intestines.

Certain neurological conditions, such as Parkinson's disease and multiple sclerosis, can affect the nerves that control stomach function, leading to gastroparesis.

It can also be caused by certain medications, including some opioid pain medications, antidepressants like venlafaxine, and allergy medications like diphenhydramine (Benadryl). It can also be caused by viral infections that can damage the stomach nerves and marijuana use.

How can you lower your risk of gastroparesis?

If you have diabetes, you can lower your risk by keeping good control of your blood sugar. You can also avoid medications that can cause gastroparesis. But it's important to know that 40% of gastroparesis cases are idiopathic (unknown reason).

GLP-1 agonists and gastroparesis

Research on semaglutide-induced gastroparesis is limited, but there have been patient reports of gastroparesis with GLP-1 agonists like tirzepatide, liraglutide, and semaglutide. However, the majority of the people who reported gastroparesis symptoms also had diabetes and their gastroparesis resolved after temporarily discontinuing the GLP-1 agonist. In some cases, diet changes (eating small frequent meals that are low in fiber and fat and avoiding carbonated beverages that may bloat the stomach) also helped resolve symptoms.

Keep in mind: We mentioned earlier there were no reports of gastroparesis in a 2 year clinical study of semaglutide use in patients with overweight or obesity. The FDA states that they can't confirm if GLP-1 agonists directly cause gastroparesis or an underlying health condition.

Remember: Gastroparesis symptoms are very similar to common semaglutide side effects. But just because these symptoms occur, it doesn't mean there's a problem. If your symptoms become severe, aren't going away, or worsen, you should let your healthcare provider know. They can help determine what steps you should take next.

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