Differential Diagnosis for Bloating and LL Quadrant Pain after Ozempic Injection

Single Most Likely Diagnosis

• Gastrointestinal side effects of Ozempic: Ozempic (semaglutide) is known to cause gastrointestinal side effects such as nausea, vomiting, diarrhea, and abdominal pain due to its mechanism of action which slows gastric emptying and can affect bowel habits. Bloating and lower left quadrant pain could be attributed to these side effects, especially if the patient has recently started the medication or has increased the dose.

Other Likely Diagnoses

• Constipation: A common side effect of Ozempic, constipation can lead to bloating and abdominal pain, including in the lower left quadrant.
• Gastroesophageal reflux disease (GERD): Although less common, some patients on Ozempic might experience worsening of GERD symptoms, which could manifest as bloating and abdominal pain.
• Inflammatory bowel disease (IBD) exacerbation: If the patient has pre-existing IBD (like Crohn's disease or ulcerative colitis), Ozempic could potentially exacerbate symptoms, leading to increased bloating and abdominal pain.

Do Not Miss Diagnoses

• Appendicitis: Although unlikely to be directly caused by Ozempic, appendicitis is a medical emergency that requires prompt diagnosis and treatment. Lower left quadrant pain could be a presentation of appendicitis, especially if the pain is severe, accompanied by fever, or if the patient's pain has migrated.
• Intestinal obstruction: A rare but serious condition that could be considered if the patient has a history of abdominal surgery or other risk factors. Ozempic's effect on bowel motility could theoretically contribute to an obstruction, though this would be extremely uncommon.
• Pancreatitis: Given Ozempic's association with an increased risk of pancreatitis, any severe abdominal pain, especially if radiating to the back, should prompt an evaluation for pancreatitis.

Rare Diagnoses

• Malabsorption: Though rare, long-term use of Ozempic could potentially lead to malabsorption issues due to its effects on the gastrointestinal system, resulting in bloating and abdominal pain.
• Small intestine bacterial overgrowth (SIBO): The slowed gastric emptying caused by Ozempic might contribute to the development of SIBO, leading to bloating and abdominal pain.
• Inflammatory response or hypersensitivity reaction to Ozempic: Extremely rare, but an allergic or hypersensitivity reaction to Ozempic could potentially cause a range of symptoms including abdominal pain and bloating.