Research indicates a possible link between Ozempic (semaglutide) and stomach paralysis (gastroparesis) or bowel injury, but further studies are needed to fully understand the risk. As a GLP-1 receptor agonist, Ozempic slows stomach emptying to help regulate blood sugar, which may lead to gastrointestinal side effects.

People with diabetes already face an increased risk of gastroparesis and bowel injury, as diabetes is the most common cause of delayed stomach emptying. Taking Ozempic may further elevate this risk. Additionally, reports of severe stomach-related side effects, including over 100 lawsuits citing stomach paralysis and intestinal blockage, have emerged since the drug's release.

What is Ozempic?

Ozempic is a once-weekly injectable medication used alongside diet and exercise to manage type 2 diabetes. It is also FDA-approved to reduce the risk of major heart-related events and worsening kidney disease in adults with type 2 diabetes. This medication belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist drug class.

Can Ozempic Cause Bowel Injury?

Bowel injury is a potential risk with Ozempic. Increased GLP-1 activity can slow gastrointestinal movement, leading to constipation and, in severe cases, intestinal blockage (ileus).

In 2023, the FDA updated Ozempic’s label to include ileus under postmarketing side effects. This decision was based on voluntary reports submitted to the FDA’s Adverse Events Reporting System. Because these reports are voluntary, the exact cause of these side effects remains unclear.

Key Symptoms and When to Seek Medical Attention

Stomach Paralysis Symptoms (Gastroparesis)

• Persistent nausea and vomiting
• Early satiety (feeling full quickly)
• Abdominal bloating and distension
• Abdominal pain or discomfort
• Unexplained weight loss
• Episodic vomiting or loss of appetite

Symptoms may be non-specific and overlap with typical gastrointestinal side effects. However, persistent or escalating symptoms should prompt a medical evaluation.

Bowel Obstruction/Ileus Symptoms

• Severe, persistent abdominal pain or swelling
• Inability to pass stool or gas
• Repeated vomiting
• Rapid heart rate or low blood pressure
• Signs of dehydration (dry mouth, decreased urination, dizziness)

Seek immediate care if you experience any of the above, as these may represent a medical emergency.

Can Ozempic Cause Stomach Paralysis?

Yes, Ozempic may contribute to stomach paralysis, though the term "paralysis" does not mean the stomach is permanently inactive. Instead, the medication slows stomach emptying, and some individuals may be more affected than others.

A study analyzing FDA safety data from 2018 to early 2022 identified 48 cases of impaired stomach emptying (26 serious and 22 non-serious) among 5,442 reports of semaglutide-related gastrointestinal issues.

Symptoms of stomach paralysis include:

• Stomach discomfort
• Bloating
• Feeling full too early after starting a meal
• Nausea

Gastrointestinal side effects are common with Ozempic. If you experience these symptoms, consult your healthcare provider.

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Is Stomach Paralysis from Ozempic Permanent?

For many patients, symptoms improve or resolve after discontinuing Ozempic, often within weeks to months. However, some cases report persistent or recurring symptoms for months or even years, and permanent gastroparesis has been noted in rare instances, particularly after prolonged use.

Because the long-term prognosis depends on individual risk factors and comorbidities, ongoing research and legal cases are closely monitoring these outcomes.

How Does Ozempic Cause Stomach and Bowel Problems?

Ozempic (semaglutide) works by mimicking the hormone GLP-1, which slows gastric emptying and gut motility as part of its effect to lower blood sugar and curb appetite. While this is usually beneficial for diabetes and weight loss, in some patients, it leads to delayed digestion, resulting in the build-up of food (“bezoars”), nausea, and, in rare cases, outright paralysis of the stomach or intestines.

Other medications (opioids, certain antidepressants, anti-Parkinson’s drugs) can have similar but usually less pronounced effects. The gold-standard test for gastroparesis is a gastric emptying study, but diagnosis is often made clinically.

How Does Ozempic Affect the Nervous and Digestive System?

Ozempic influences digestion by activating GLP-1 receptors, which slow stomach emptying and intestinal movement. It affects the vagus nerve, a key component of the parasympathetic nervous system that regulates digestion.

People with diabetes are at higher risk for intestinal blockage due to diabetic neuropathy, a type of nerve damage caused by high blood sugar levels. This damage can impair digestive function, compounding the effects of Ozempic.

How Common Are Stomach Paralysis and Bowel Blockage with Ozempic?

Semaglutide-containing drugs like Ozempic are associated with a noticeably higher risk of gastroparesis (“stomach paralysis”) than most other diabetes or weight-loss medications. A large-scale study found the incidence rate of gastroparesis among Ozempic users to be about 7.2 per 1,000 person-years—notably higher than oral semaglutide (Rybelsus) or other agents.

Bowel injury is also a concern. In September 2023, the FDA updated Ozempic’s label to warn about ileus—a potentially life-threatening bowel obstruction. As of mid-2024, there have been dozens of reported cases, including fatalities, although direct causality is not always established.

Key Takeaways

While Ozempic can cause significant gastrointestinal side effects, the benefits may outweigh the risks for many patients. Always discuss potential side effects with your healthcare provider, who can monitor for complications and provide guidance on managing symptoms.

This is not all the information you need to know about Ozempic (semaglutide) for safe and effective use and does not take the place of your healthcare provider’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

1. Aneke-Nash, C., Hung, K. S., Wall-Wieler, E., Zheng, F., & Sharaiha, R. Z. (2025). Comparing the risk of gastroparesis following different modalities for treating obesity: semaglutide versus bupropion-naltrexone versus sleeve gastrectomy - a retrospective cohort study. BMJ open gastroenterology, 12(1), e001704. https://doi.org/10.1136/bmjgast-2024-001704
2. Andrews, C. N. 2008. Effects of glucagon-like peptide-1 and sympathetic stimulation on gastric accommodation in humans. In: Neurogastroenterology and Motility. DOI: https://doi.org/10.1111%2Fj.1365-2982.2007.00923.x
3. Chaudhry, A., et. al. 2024. Tendency of Semaglutide to Induce Gastroparesis: A Case Report. In: Cureus. DOI: https://doi.org/10.7759%2Fcureus.52564
4. Fallie, J. L., et. al. 2021. Incretin-Based Drugs and Risk of Intestinal Obstruction Among Patients With Type 2 Diabetes. In: Clinical Pharmacology and Therapeutics. DOI: https://doi.org/10.1002/cpt.2430
5. Igburuke, L. E., Tawde, P., Oparaocha, V., Horani, M. H., Salim, Y., Salim, M., & Salim, O. (2024). 12322 Unraveling The Complexity Of Stiff-Person Syndrome: A Case Of Ozempic-Induced Gastric Paralysis In A Patient With Comorbid Type 2 Diabetes Mellitus. Journal of the Endocrine Society, 8(Suppl 1), bvae163.993. https://doi.org/10.1210/jendso/bvae163.993
6. Llamas, M. 2024. Ozempic Lawsuit. In: Drugwatch. Accessed July 24, 2024 at https://www.drugwatch.com/legal/ozempic-lawsuit/
7. Lu, J., et. al. 2023. A potentially serious adverse effect of GLP-1 receptor agonists. In: Acta Pharmaceutica Sinica B. DOI: https://doi.org/10.1016/j.apsb.2023.02.020
8. National Institute of Diabetes and Digestive and Kidney Diseases. (2021). How Does Gastroparesis Affect People with Diabetes? Accessed July 24, 2024 at https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/how-gastroparesis-affect-people-with-diabetes
9. Ozempic [package insert]. Updated September 2023. Novo Nordisk. Accessed July 24, 2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
10. Shu, Y., et. al. 2022. Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system. In: Frontiers in Public Health. DOI: https://doi.org/10.3389/fpubh.2022.996179
11. U.S. Food and Drug Administration. Drug Safety-related Labeling Changes (SrLC). Accessed July 24, 2024 at https://www.accessdata.fda.gov/scripts/cder/safetylabelingchanges/index.cfm?event=searchdetail.page&DrugNameID=2183

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