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Study breakdown

First Case Report: Semaglutide Causes Eosinophilic Duodenitis Leading to Bowel Obstruction

evidence
The takeaway

A patient on oral semaglutide developed severe eosinophilic infiltration of the duodenum causing mechanical bowel obstruction with fecal vomiting—the first reported case of this complication.

First reported case

Semaglutide linked to eosinophilic duodenitis causing mechanical bowel obstruction

What the researchers found

First reported case of semaglutide-associated eosinophilic duodenitis causing high bowel obstruction, with endoscopic and histological confirmation of marked eosinophilic infiltration.

Why it matters

As millions more people take GLP-1 drugs, recognizing rare but serious GI adverse effects is critical. This case adds eosinophilic gastrointestinal disease to the differential diagnosis for GLP-1 patients with severe GI symptoms.

How the study worked

Single case report with endoscopic, histological, and clinical documentation, plus literature review.

What this study cannot tell us

Single case report—cannot establish causation. The patient may have had pre-existing susceptibility to eosinophilic GI disease. No ability to estimate incidence from a single case.

How to read the evidence

Single case report with histological confirmation. Documents a novel adverse effect but cannot establish incidence or causation.

When this study was published

Published in 2025, reporting a novel adverse effect as GLP-1 drug use expands globally.

The bigger picture

This case expands the known adverse effect profile of GLP-1 receptor agonists beyond the common GI symptoms (nausea, vomiting) to include potentially serious eosinophilic gastrointestinal disease.

Questions still open

  • What is the mechanism by which GLP-1 drugs could trigger eosinophilic gastrointestinal infiltration?
  • Should patients with known eosinophilic GI conditions avoid GLP-1 receptor agonists?
  • How often does subclinical eosinophilic inflammation occur in GLP-1 drug users?

Common questions

What happened in this case?
A patient on oral semaglutide developed progressive stomach problems that worsened until they had fecal vomiting from a bowel obstruction. Testing revealed their duodenum was inflamed with eosinophils, a type of immune cell.
Should I be worried about this if I take semaglutide?
This appears to be extremely rare—it is the first reported case. However, if you develop severe or unusual upper GI symptoms on semaglutide, tell your doctor promptly so they can evaluate appropriately.

Read the original research

GLP-1 receptor agonist-associated eosinophilic duodenitis presenting as a bowel obstruction : a case report and literature review.

Acta gastro-enterologica Belgica, 89(1), 93-96

Citation

Davidts, S; Loumaye, A; Dano, H; Annet, L; Delire, B. (2026). GLP-1 receptor agonist-associated eosinophilic duodenitis presenting as a bowel obstruction : a case report and literature review.. Acta gastro-enterologica Belgica, 89(1), 93-96. https://doi.org/10.51821/89.1.14613