P4258 - I Miss Eating: Medication-Induced Gastroparesis from Semaglutide

Paul Gomez, MD¹, Victor Arce Gutierrez, MD¹, Natasha Narang, DO¹, Aaron Goldberg, MD^2
1University of Arizona College of Medicine, Phoenix, AZ; ²Carl T. Hayden Veterans Affairs Medical Center, Phoenix, AZ

Introduction: Gastroparesis is a syndrome of delayed gastric emptying in the absence of mechanical obstruction. Common symptoms include nausea, vomiting, and upper abdominal pain. These cardinal symptoms can be challenging to treat and lead to poor quality of life and increased economic burden for patients. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical. We present a case of medication induced gastroparesis in a patient with long-standing diabetes who was started on semaglutide.



Case Description/Methods: A 73-year-old male with a 9-year history of diabetes mellitus type 2 who was referred to GI clinic for evaluation of 6 months of nausea, vomiting, and abdominal pain. His diabetes mellitus was well controlled at the time with a HbA1c of 5.2%. An upper endoscopy was performed and showed some retained food in the stomach but no evidence of obstruction. A scintigraphic gastric emptying study was completed and showed 33% gastric retention at four hours consistent with moderate gastroparesis. A detailed medication review was done and notable for the patient being started on semaglutide approximately one month prior to the onset of symptoms. Prior to being on semaglutide his diabetes mellitus was uncontrolled and he had an HbA1c of 13%. Therefore, dietary modifications and pharmacologic treatment were trialed initially, but his gastroparesis symptoms did not improve. In coordination with endocrinology, decision made to stop semaglutide and symptoms completely resolved within one month. A repeat gastric emptying study was performed and no longer showed delayed gastric emptying.



Discussion: Studies have shown that Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide can cause delayed gastric emptying. The desired side effect of weight loss has led to a rapid rise in popularity for this class of medication. This case illustrates the importance of not missing a diagnosis of medication induced gastroparesis which can be reversible.




Disclosures:


Paul Gomez, MD¹, Victor Arce Gutierrez, MD¹, Natasha Narang, DO¹, Aaron Goldberg, MD². P4258 - I Miss Eating: Medication-Induced Gastroparesis from Semaglutide, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.