Medication-Induced Gastroparesis: A Case Report

Abstract

Gastroparesis is a commonly diagnosed gastrointestinal disorder with a high prevalence globally and high disease burden to those afflicted with it. Etiologies are variable with idiopathic and diabetes being the most common causes of gastroparesis. Management of gastroparesis depends on the etiology, and accurate diagnosis is required for better targeted therapy. Medication-induced gastroparesis is reversible, and discontinuing the medication is generally curative. This case report discusses 2 cases of medication-induced gastroparesis which were initially diagnosed as diabetic gastroparesis, and thorough history taking revealed the cause to be medication induced. Repeat studies following medication discontinuation revealed improvement in symptoms and resolution of gastroparesis. Further research needs to be done to assess the frequency of misdiagnosing diabetic patients with gastroparesis due to medications, specifically glucagon-like peptide-1 receptor agonists which are increasingly being used in diabetics.

Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss

“…Glucagon-like peptide 1 (GLP-1) agonists are medications approved for treatment of diabetes that recently have also been used off label for weight loss . Studies have found increased risks of gastrointestinal adverse events (biliary disease, pancreatitis, bowel obstruction, and gastroparesis) in patients with diabetes . Because such patients have higher baseline risk for gastrointestinal adverse events, risk in patients taking these drugs for other indications may differ.…”

Role of gastric peroral endoscopic myotomy (GPOEM) in chronic gastroparesis management after pancreas transplantation

“…Several medications can be associated with gastrointestinal distress, and DGE more specifically. 31,32 Mycophenolate mofetil is known to cause some GI complaints, often in the form of diarrhea. 33,34 One study measured GI contractility in multiple immunosuppressants but did not note any change in GI transit with mycophenolate mofetil.…”

In-Home Management of Diabetes and Obesity

“…There have been case reports of medication-induced gastroparesis that, while initially thought to be diabetic gastroparesis, resolved when the medication was discontinued (Kalas et al, 2021). There have been additional case reports in the perioperative setting of an increased risk of aspiration of stomach contents during anesthesia due to the delayed gastric emptying with the use of GLP-1 RA medications (Kalas et al, 2021). SGLT-2i medications work by blocking glucose and sodium reabsorption in the kidneys and increasing glucose excretion in the urine (Simes & MacGregor, 2019).…”

“…There have been recent media reports of "Ozempic Face" that attributes facial aging to use of the medication, but the loss of facial fat can occur with any weight loss method (Suran, 2023). There have been case reports of medication-induced gastroparesis that, while initially thought to be diabetic gastroparesis, resolved when the medication was discontinued (Kalas et al, 2021). There have been additional case reports in the perioperative setting of an increased risk of aspiration of stomach contents during anesthesia due to the delayed gastric emptying with the use of GLP-1 RA medications (Kalas et al, 2021).…”