The use of GLP-1 inhibitors (glucagon-like peptide-1 receptor agonists) has surged in recent years. They are prescribed for blood sugar management in Type 2 diabetes and weight loss. Although highly effective, they do have a profound impact on the gastrointestinal (GI) tract. Because they work by changing how the digestive tract functions, the majority of patients experience some GI side effects.

The Effects On Gut Function

GLP-1 inhibitors work by drastically slowing down digestion. This results in delayed stomach emptying to keep you feeling fuller for longer. It also increases the time that it takes for food to move through the intestines. This reduced gut motility can lower stomach acid output. It can also change the bacterial makeup of the microbiome.

Common Gastrointestinal Side Effects

Digestive symptoms are the most commonly reported side effects by patients taking GLP-1 inhibitors. These adverse effects are usually mild to moderate. The issues can be relieved by following GLP-1 inhibitor-specific dietary recommendations. The symptoms typically occur when first starting treatment or increasing your dosage. They usually subside as your body adjusts to the medication. 

The most common side effects include:

  • Nausea
  • Vomiting
  • Bloating and gas
  • Diarrhea
  • Constipation
  • Heartburn
  • Abdominal discomfort

Rare Gastrointestinal Complications

Due to the slowing of the digestive system caused by GLP-1 inhibitors, some patients may be at risk for more serious gastrointestinal complications.

  • Bowel obstruction (a blockage caused by severe constipation)
  • Gastroparesis (a condition where the stomach takes too long to empty)
  • Gallstones (deposits that form in the gallbladder)
  • Pancreatitis (inflammation of the pancreas)

If you experience ongoing or severe abdominal pain, bloating, nausea and vomiting, inability to pass gas or have a bowel movement, fever and chills, rapid heart rate, yellowing of the skin or eyes, or changes in stool or urine, seek urgent medical care. They may be signs of a serious complication.

How To Prevent Side Effects And Complications

Preventing side effects and more serious complications involves following an optimized dosing schedule and the dietary guidelines provided by your doctor.

  • Dosing: GLP-1 inhibitor medication should start at the lowest effective dose with dosage increases undertaken slowly over a period of weeks. Dosage escalation should be paused if symptoms remain present or stepped back if new symptoms like nausea develop. 
  • Nutrition: Limit or avoid alcohol, as well as fatty, sweet or spicy foods. Follow a healthy, low-fat diet. Emphasize water and water-rich foods, especially if dehydrated. Water should be sipped throughout the day rather than ingested in large quantities. Ensure that you are getting enough dietary fiber. If you are low in fiber when you begin treatment, boost fiber intake slowly to prevent constipation.
  • Eating Habits: Many patients find that small habit modifications help significantly in the prevention of gastrointestinal complaints. This includes eating smaller meals more frequently, eating slowly, stopping at satiety, and avoiding activity and lying down after a meal. Some patients find that keeping a food diary can help identify foods that trigger symptoms.

Managing Symptoms From GLP-1 Inhibitors

The recommendations for symptom management are the same as those for prevention. These dietary guidelines help manage symptoms if they occur. If you are suffering from nausea, vomiting or other side effects, it’s also important to prevent dehydration, treat specific symptoms (using “over the counter” medications if necessary) and seek clinical guidance about dosing. 

The team at GastroIntestinal Specialists, A.M.C., treats multiple conditions and diseases of the gastrointestinal (GI) tract. Our board-certified physicians have more than 325 years of combined experience in providing quality care you can trust. To schedule an appointment, call (318) 631-9121 or visit gis.md.