Semaglutide linked to first reported case of gastric pneumatosis—air in the stomach wall | Research

The takeaway

First case report of gastric pneumatosis (air in the stomach wall) associated with semaglutide use, adding a rare but potentially serious GI complication to the expanding GLP-1 drug safety profile.

First gastric pneumatosis case
Semaglutide is associated with the first reported case of air in the stomach wall—a novel GI complication expanding the growing safety profile of GLP-1 drugs

What the researchers found

First case: gastric pneumatosis on semaglutide. Novel GI complication not previously described. GLP-1 drugs cause delayed gastric emptying (possible mechanism). Can be benign or indicate serious pathology.

Why it matters

With millions on semaglutide, even rare GI complications must be documented. Gastric pneumatosis can sometimes indicate life-threatening conditions, making recognition important.

How the study worked

Single case report.

What this study cannot tell us

Single case. Cannot prove causation. Very rare. Gastric pneumatosis has multiple causes.

How to read the evidence

Single case report—first description.

When this study was published

Published in 2025.

The bigger picture

The GLP-1 drug GI side effect spectrum continues to expand: from nausea to gastroparesis to intussusception to now gastric pneumatosis. Each new report refines the safety picture for clinicians.

Questions still open

Is the pneumatosis from delayed gastric emptying or another mechanism?
How should gastric pneumatosis on GLP-1 drugs be managed?
Should imaging findings be interpreted differently in GLP-1 drug users?

Common questions

What is gastric pneumatosis?

It is air trapped within the wall of the stomach, visible on imaging. It can be a harmless finding or indicate serious problems like reduced blood flow or infection. This is the first case reported in a semaglutide user, possibly related to the drug's effects on stomach motility.

Should I be worried about this on semaglutide?

This is extremely rare—a single case in millions of users. However, if you have unusual abdominal symptoms on semaglutide beyond typical nausea (severe pain, distension), seek medical attention. Most GI side effects of GLP-1 drugs are mild and manageable.

Read the original research

Semaglutide-Associated Gastric Pneumatosis.

ACG case reports journal, 12(1), e01579

View on PubMed ↗Publisher’s paper ↗

Citation

Turunen, Andrew M; Coombs, Reilly A; Garg, Sushil Kumar. (2025). Semaglutide-Associated Gastric Pneumatosis.. ACG case reports journal, 12(1), e01579. https://doi.org/10.14309/crj.0000000000001579