What is ileus and why is it a concern with GLP-1 medications?

Ileus (paralysis of the intestines) is a serious condition where the intestines stop moving food through the digestive tract. While extremely rare, the FDA added warnings about ileus to GLP-1 labeling after post-marketing reports. GLP-1s slow gastric emptying and intestinal motility as part of their mechanism, and in rare cases, this may progress to complete intestinal paralysis. Symptoms include: severe abdominal pain and bloating, inability to pass gas or stool, nausea and vomiting, and abdominal distension. Ileus is a medical emergency requiring immediate hospitalization. Risk factors may include: concurrent use of other medications that slow gut motility (opioids, anticholinergics), history of gastrointestinal surgery, severe constipation, and higher GLP-1 doses. If you experience severe abdominal symptoms with bloating and inability to pass gas or stool, seek emergency care immediately. Prevention includes: maintaining adequate hydration, regular physical activity to promote gut motility, addressing constipation promptly, and reporting severe or persistent GI symptoms to your provider.