Can Ozempic (semaglutide) cause constipation and stercoral colitis?

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Last updated: March 18, 2025View editorial policy

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From the Guidelines

Yes, Ozempic (semaglutide) can cause constipation and in rare cases may contribute to stercoral colitis. Constipation is a common side effect of Ozempic, affecting approximately 5-10% of patients taking the medication, as noted in the guidelines for pharmacological interventions for adults with obesity 1. The constipation occurs because Ozempic, as a GLP-1 receptor agonist, slows gastric emptying and intestinal transit time, which can lead to harder stools and less frequent bowel movements. Some key points to consider when managing constipation while taking Ozempic include:

  • Increasing fluid intake to at least 2 liters daily
  • Consuming more dietary fiber (25-30g daily)
  • Engaging in regular physical activity
  • Establishing a consistent bathroom routine These steps can help manage constipation and reduce the risk of complications. If constipation becomes severe or is accompanied by intense abdominal pain, bloating, or inability to pass gas, contact your healthcare provider immediately as these could be signs of stercoral colitis or other serious complications. Additionally, some prokinetic treatments, such as prucalopride, may be useful in managing constipation, as they can help improve intestinal motility and reduce symptoms of constipation 1. However, it's essential to consult with a healthcare provider before starting any new medications or treatments. Overall, while Ozempic can cause constipation, there are steps that can be taken to manage this side effect and reduce the risk of complications.

From the FDA Drug Label

The most common adverse reactions, reported in ≥5% of patients treated with OZEMPIC are: nausea, vomiting, diarrhea, abdominal pain and constipation (6.1). The most common side effects of OZEMPIC may include nausea, vomiting, diarrhea, stomach (abdominal) pain and constipation.

Constipation is a reported side effect of Ozempic (semaglutide) 2 2. However, there is no direct information in the provided drug labels about Ozempic causing stercoral colitis.

From the Research

Constipation and Stercoral Colitis

  • Constipation is a common symptom associated with stercoral colitis, as seen in studies 3, 4, 5, 6, 7.
  • Stercoral colitis is a rare inflammatory condition of the distal large bowel and rectum resulting from accumulation of impacted stool, which can lead to complications such as bowel ulceration, ischemia, perforation, peritonitis, and sepsis 3.
  • The diagnosis of stercoral colitis can be secured with cross-sectional radiography, including computed tomography of the abdomen and pelvis 3, 4, 6, 7.

Ozempic (Semaglutide) and Constipation

  • There is no direct evidence in the provided studies linking Ozempic (semaglutide) to constipation and stercoral colitis.
  • However, it is known that certain medications, such as opiates, can cause constipation, which can lead to stercoral colitis 6.
  • Further research would be needed to determine if Ozempic (semaglutide) can cause constipation and increase the risk of stercoral colitis.

Risk Factors for Stercoral Colitis

  • Chronic constipation is a major risk factor for stercoral colitis, particularly in elderly patients with comorbid diseases 4, 5, 6, 7.
  • Other risk factors may include the use of certain medications, such as opiates, and underlying medical conditions 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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