A rise in popularity in glucagon-like peptide 1 receptor agonists such as Ozempic and Wegovy is causing concern in the medical community over potential side effects for various physician specialties, according to a July 17 report from Medscape.
Here are three potential health effects associated with GLP-1s and gastroenterology care that specialists should be aware of:
1. Risk of aspiration
GLP-1s increase the amount of food that may stay in a patient's stomach long term, causing concern for patients who are supposed to fast for procedures.
Gastroenterologists should be aware of an elevated risk for patient aspiration during endoscopy procedures. However, in August, five GI groups issued a statement saying that while physicians should "exercise caution" in patients on GLP-1s, they did not recommend patients fully stop taking the medication before a routine endoscopy.
A study published in The American Journal of Gastroenterology reviewed 16,295 patients undergoing an upper endoscopy, among whom 306 were taking GLP-1s. It showed a higher rate of solid gastric residue among those taking GLP-1 RAs compared with controls, but there were no recorded incidents of procedural complications or aspiration.
2. GI adverse events
An analysis of 10,328 new GLP-1 users found that GI adverse events were possible in new patients.
The highest number of adverse events in this cohort were abdominal pain (57.6%), constipation (30.4%), diarrhea (32.7%), nausea and vomiting (23.4%), GI bleeding (15.9%), gastroparesis (5.1%) and pancreatitis (3.4%).
A 2023 report in JAMA also observed that the risk for bowel obstruction is elevated among patients using GLP-1s.
3. A lack of hepatic concerns
GLP-1s may reduce the accumulation of hepatic triglycerides and expression of several collagen genes. Some preclinical data suggest a risk reduction for progression to hepatocellular carcinoma, according to the report.
In a recent study that reviewed 91,479 patients using GLP-1s, investigators demonstrated this treatment was associated with a significant reduction in the composite primary endpoint of hepatocellular carcinoma, as well as both compensated and decompensated cirrhosis.