Can Wegovy cause gastritis? Wegovy (semaglutide) is a GLP-1 receptor agonist licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities. Whilst gastritis—inflammation of the stomach lining—is not specifically listed as a recognised adverse effect in the Summary of Product Characteristics, Wegovy commonly causes gastrointestinal symptoms that may mimic gastric discomfort. The medication slows gastric emptying, which may theoretically exacerbate pre-existing gastritis or cause gastritis-like symptoms. Understanding the distinction between expected side effects and true gastritis is essential for safe treatment.

Can Wegovy Cause Gastritis?

Wegovy (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities. Whilst gastritis—inflammation of the stomach lining—is not specifically listed as a recognised adverse effect in the Summary of Product Characteristics (SmPC), Wegovy commonly causes gastrointestinal symptoms that may mimic or potentially contribute to gastric discomfort.

The mechanism of action of semaglutide involves slowing gastric emptying, which prolongs the time food remains in the stomach. This delayed emptying (most pronounced early in treatment and typically attenuating over time) may theoretically increase gastric distension, potentially exacerbating pre-existing gastritis or causing gastritis-like symptoms. There is no established direct link between Wegovy and the development of true gastritis (confirmed by endoscopy), but the drug's gastrointestinal side effects are well documented.

Common gastrointestinal adverse effects reported with Wegovy include:

• Nausea (affecting approximately 44% of patients)

• Vomiting (approximately 24%)

• Dyspepsia (indigestion)

• Abdominal pain

• Constipation

These symptoms typically occur during dose escalation and often improve over time as the body adjusts to the medication. However, persistent or severe upper abdominal discomfort warrants clinical assessment to exclude gastritis or other gastrointestinal pathology. Patients with a history of peptic ulcer disease or gastritis should discuss this with their prescriber before starting Wegovy, as pre-existing gastric conditions may be aggravated by GLP-1 receptor agonists. Semaglutide is not recommended in patients with severe gastrointestinal disease, including severe gastroparesis.

Recognising Gastritis Symptoms While Taking Wegovy

Distinguishing between common Wegovy-related gastrointestinal side effects and symptoms suggestive of gastritis can be challenging, as there is considerable overlap. Gastritis typically presents with upper abdominal pain or discomfort, often described as a gnawing or burning sensation in the epigastric region (upper central abdomen). This discomfort may worsen or improve with eating, depending on the underlying cause.

Key symptoms that may indicate gastritis include:

• Persistent upper abdominal pain or burning that does not resolve with standard antacids

• Nausea and vomiting, particularly if vomiting contains blood or resembles coffee grounds

• Loss of appetite beyond the expected appetite suppression from Wegovy

• Bloating and early satiety (feeling full quickly after eating small amounts)

• Indigestion (dyspepsia) that is new, persistent, or worsening

It is important to note that whilst Wegovy commonly causes nausea and reduced appetite as part of its therapeutic effect, severe or persistent symptoms warrant further investigation. Gastritis can be caused by various factors including Helicobacter pylori infection, non-steroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, or stress.

Patients taking Wegovy should monitor for alarm features that suggest more serious pathology:

• Unintentional weight loss beyond expected therapeutic weight reduction

• Difficulty swallowing (dysphagia)

• Persistent vomiting

• Evidence of gastrointestinal bleeding (black, tarry stools or blood in vomit)

• Severe, unrelenting abdominal pain, especially if radiating to the back (which may indicate pancreatitis)

• Right upper abdominal pain with or without fever/jaundice (which may indicate gallbladder disease)

If you experience these symptoms whilst taking Wegovy, it is essential to contact your GP promptly for clinical assessment. Your doctor may arrange investigations such as blood tests, Helicobacter pylori testing (note that proton pump inhibitors should be stopped approximately 2 weeks before testing where possible), or referral for endoscopy if gastritis or other upper gastrointestinal pathology is suspected.

Managing Stomach Problems on Wegovy

Most gastrointestinal side effects associated with Wegovy are mild to moderate and improve over the first few weeks of treatment as the body adapts to the medication. However, proactive management strategies can significantly reduce discomfort and improve treatment tolerability.

Dietary modifications are often the first-line approach to managing stomach problems on Wegovy:

• Eat smaller, more frequent meals rather than large portions, as this reduces gastric distension and works with the delayed gastric emptying caused by semaglutide

• Avoid high-fat, greasy, or spicy foods, which can exacerbate nausea and slow digestion further

• Stay well hydrated, sipping water throughout the day, but avoid drinking large volumes with meals

• Limit alcohol and caffeine, both of which can irritate the gastric mucosa

• Avoid lying down immediately after eating; remain upright for at least 2–3 hours after meals to reduce reflux symptoms

Medication adjustments may be necessary if symptoms are severe or persistent. Your prescriber may consider:

• Slowing the dose escalation schedule to allow more time for gastrointestinal adaptation

• Temporarily reducing to a previously tolerated dose or maintaining the 1.7 mg dose if 2.4 mg is not tolerated

• Prescribing anti-emetics for short-term nausea management in selected cases. Note that metoclopramide should only be used for a maximum of 5 days due to risk of neurological side effects. Domperidone has restrictions due to cardiac risks (including QT prolongation) and should be used with caution

• Proton pump inhibitors (PPIs) such as omeprazole or lansoprazole if dyspepsia or reflux symptoms are prominent

Avoiding gastric irritants is crucial. If you regularly take NSAIDs (such as ibuprofen) for pain relief, discuss alternatives with your GP, as these medications can cause or worsen gastritis. Paracetamol is generally a safer option for pain management whilst taking Wegovy.

Do not stop or adjust your Wegovy treatment without speaking to your prescriber. If gastrointestinal symptoms are intolerable, your doctor can adjust the treatment plan appropriately, which may include temporarily reducing the dose or considering alternative weight management strategies.

If you suspect you are experiencing side effects from Wegovy, you can report these through the MHRA Yellow Card scheme (website or app).

When to Seek Medical Advice About Wegovy and Gastritis

Whilst mild gastrointestinal symptoms are expected with Wegovy, certain situations require prompt medical assessment to exclude serious complications or underlying pathology.

Contact your GP urgently if you experience:

• Severe, persistent abdominal pain that does not improve with simple measures or worsens over time

• Repeated vomiting that prevents you from keeping down fluids or medication

• Signs of gastrointestinal bleeding, including vomiting blood (haematemesis), coffee-ground vomit, or black, tarry stools (melaena)

• Symptoms of dehydration such as dizziness, reduced urine output, or extreme thirst, particularly if accompanied by vomiting or diarrhoea

• Unexplained weight loss beyond the expected therapeutic effect, or loss of appetite that persists beyond the initial weeks of treatment

• New or worsening dysphagia (difficulty swallowing)

Seek immediate medical attention (call 999 or attend A&E) if you develop:

• Sudden, severe abdominal pain

• Vomiting large amounts of blood

• Signs of shock (rapid heartbeat, confusion, cold/clammy skin, rapid breathing)

According to NICE guidance (NG12), urgent referral for suspected upper gastrointestinal cancer (within two weeks) should be considered for:

• Patients with dysphagia at any age

• Patients aged 55 and over with weight loss AND upper abdominal pain, reflux or dyspepsia

• Patients with an upper abdominal mass

If gastritis is confirmed through investigation, your healthcare team will work with you to determine whether Wegovy can be continued safely, potentially with additional gastro-protective medication, or whether an alternative weight management approach is more appropriate. Speak to your prescriber before making any changes to your Wegovy treatment, as they need to assess your individual circumstances and provide appropriate follow-up care.

For urgent but non-emergency advice, you can contact NHS 111. Regular monitoring and open communication with your healthcare team are essential for safe and effective use of Wegovy. If you have concerns about gastrointestinal symptoms, do not hesitate to seek advice—early intervention can prevent complications and ensure optimal treatment outcomes.

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