Semaglutide-Induced Ischemic Colitis in A Middle-Aged Female Without Vascular Risk Factors
Marwan Joma1, Abdulrahman M Karam1, Wasef Sayeh2
1Department of Internal Medicine, University of Toledo Medical Center, Toledo, USA.
European Journal of Case Reports in Internal Medicine
|July 17, 2026
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may be linked to ischemic colitis (IC) in patients without typical risk factors. Early evaluation for IC is crucial if abdominal pain and rectal bleeding occur during GLP-1RA treatment.
Area of Science:
- Gastroenterology
- Endocrinology
- Pharmacology
Background:
- Ischemic colitis (IC) is often associated with vascular risk factors.
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes and obesity management.
Purpose of the Study:
- To report a case of ischemic colitis in a patient without traditional risk factors following semaglutide initiation.
- To highlight a potential association between GLP-1RAs and IC, emphasizing rare adverse effects.
Main Methods:
- Case report of a 53-year-old woman.
- Clinical presentation: acute abdominal pain and haematochezia.
- Diagnostic workup: imaging, colonoscopy, biopsy, and infectious workup.
Main Results:
- Ischemic colitis was confirmed via colonoscopy and biopsy.
- Infectious workup was negative.
- Symptoms resolved after semaglutide discontinuation and supportive care.
Conclusions:
- GLP-1RAs may be associated with IC, even in patients lacking vascular risk factors.
- Heightened clinical suspicion is needed for atypical presentations of IC.
- Early evaluation and discontinuation of the suspected agent are vital for recovery.
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