Semaglutide-Induced Ischemic Colitis in A Middle-Aged Female Without Vascular Risk Factors

Ischemic colitis (IC) typically occurs in patients with vascular risk factors. We report a case of a 53-year-old woman without comorbidities who developed IC after initiating semaglutide. She presented with acute abdominal pain and haematochezia. Imaging, colonoscopy, and biopsy confirmed IC, while infectious workup was negative. Symptoms resolved following discontinuation of semaglutide and supportive care. This case highlights a potential association between glucagon-like peptide-1 receptor agonists and IC and underscores the importance of recognizing rare adverse effects in patients without traditional risk factors.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may be associated with ischemic colitis even in patients without traditional vascular risk factors, highlighting the need for heightened clinical suspicion in atypical presentations.New-onset abdominal pain and haematochezia in patients receiving GLP-1RAs should prompt early evaluation for ischemic colitis, including imaging and endoscopic assessment to exclude alternative diagnoses.Prompt discontinuation of the suspected offending agent and supportive management can lead to complete clinical recovery, emphasizing the importance of early recognition and intervention.