Ozempic and diverticulitis: Risks, side effects, and what you need to know

Ozempic (semaglutide) is a popular GLP-1 drug used for diabetes and weight loss, and its use has grown rapidly in recent years. Diverticulitis is inflammation of small pouches in the colon and is quite common in older adults.

It can be difficult to tell the difference between Ozempic’s digestive side effects and a true diverticulitis flare-up. Although both may cause abdominal discomfort, they are separate conditions and require different types of care.

Ozempic does not directly cause diverticulitis. Since it slows digestion, it can sometimes mimic or worsen gut symptoms, which may create concern for people with diverticular disease.

Concerned about Ozempic and diverticulitis? Learn if semaglutide causes flares, how to distinguish Ozempic side effects from a diverticulitis infection, and tips for safely managing gut health.

Understanding the basics

People with diverticulitis and obesity often try to lose weight to improve their overall health, and Ozempic has become a popular option. But since it can cause stomach side effects, many worry if it could worsen their gut symptoms.

The Ozempic era has transformed weight loss and diabetes care, but many people with sensitive stomachs now wonder: What will it do to my gut?

Continue reading as we address all your questions about Ozempic and gut health in a clear and informed manner.

What is Ozempic?

Ozempic (semaglutide) is an FDA-approved Trusted sourceU.S. Food and Drug AdministrationFederal regulatory agency for food and health-related productsGo to source once-weekly injectable medication for people with type 2 diabetes and is also used off-label for weight management Trusted sourcePubMed Central (PMC)PubMed Central is the National Library of Medicine's free full-text archive of biomedical and life sciences journal literatureGo to source .

Semaglutide acts as a glucagon-like peptide-1 (GLP-1 receptor agonist) that occupies GLP-1 receptors and mimics the action of human glucagon-like peptide-1 hormone. It closely resembles the human GLP-1 hormone in structure (about 94% similarity Trusted sourcePubMedPubMed is a free database of biomedical literature citations and abstracts, maintained by the National Library of MedicineGo to source ), allowing it to mimic its effects on blood sugar control and digestion.

Apart from improving blood sugar in type 2 diabetes and promoting significant weight loss Trusted sourcePubMedPubMed is a free database of biomedical literature citations and abstracts, maintained by the National Library of MedicineGo to source , Ozempic is also FDA-approved for reducing the risk of heart diseases Trusted sourceNew England Journal of MedicineA prestigious weekly medical journal published by the Massachusetts Medical SocietyGo to source , worsening kidney disease, end-stage kidney disease, and death in patients with chronic kidney disease and type 2 diabetes.

Ozempic is manufactured by Novo Nordisk. The company holds the patent for Ozempic. There is no generic version of Ozempic in the United States.

Ozempic works in the following ways:

• The medication mimics the natural GLP-1 hormone in the body by occupying GLP-1 receptors in the brain. The GLP-1 hormone regulates appetite after food intake. When semaglutide occupies its receptors, it gives you a feeling of fullness and reduces appetite.

• Similar to the GLP-1 hormone, the medication stimulates insulin release from the pancreas when blood sugar is high.

• Ozempic reduces glucagon secretion from the alpha cells of the pancreas. Glucagon increases blood sugar levels. Its inhibition lowers blood glucose levels.

• The medication slows down gastric emptying, which means food moves from your stomach to the intestine at a slower rate, giving you a feeling of fullness for a longer time, and you experience fewer hunger cravings.

• Ozempic affects the hunger control centre of the brain to suppress appetite and promote satiety.

Like other GLP-1 medications, Ozempic also has potential side effects. These side effects are usually less common at lower doses and may be noticeable at higher doses.

The  most common side effects Trusted sourceNew England Journal of MedicineA prestigious weekly medical journal published by the Massachusetts Medical SocietyGo to source of Ozempic are:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Stomach pain

• Gastrointestinal problems

• Decreased appetite

Rare and serious side effects include:

• Pancreatitis

• Diabetic retinopathy

• Severe abdominal pain

• Low blood sugar

• Kidney/ Gallbladder problems

Whenever you experience these side effects, discuss them with your healthcare provider. They will adjust the dosage according to your body’s response and the severity of side effects. If the side effects are intolerable, they may switch to a different medication.

What is diverticulitis?

Diverticulitis is a digestive condition wherein small pouches (diverticula) in the wall of the colon (large intestine) become swollen or infected. These pouches are common with age, but a problem arises when they get irritated or infected.

Common triggers that can exaggerate the risk of diverticulitis include a low-fiber diet, constipation, and frequent straining during bowel movements. Certain medicines, such as NSAIDs and steroids, are also risk factors for a flare-up.

Classic symptoms of diverticulitis Trusted sourceMedlinePlusOnline information service produced by the United States National Library of MedicineGo to source include:

• Pain in the abdomen, usually on the lower left side

• Fever with chills

• Bloating or a swollen belly

• Nausea and vomiting

• Changes in bowel habits, like constipation or diarrhea

• Rectal bleeding, which may appear bright red

• Tenderness or a lump felt in the abdomen

Symptoms of diverticulitis can differ from person to person, and some people may have only mild symptoms or none at all. If left untreated, it can lead to serious problems like infection (abscesses), a tear in the colon (perforation), or abnormal connections between organs (fistulas).

Ozempic and diverticulitis

When digestion slows down, constipation can occur. This can increase pressure inside the colon, which may irritate existing pouches and potentially trigger a diverticulitis flare.

Ozempic can be used in people with diverticulitis, but its gastrointestinal side effects need to be watched closely. It is important for your medical provider to review other medicines you take, as some drugs like antibiotics or pain medicines may need dose changes. Always discuss the benefits and risks with your healthcare provider before using it.

Side effects of Ozempic in people with diverticulitis

Ozempic or any other weight loss drug can cause stomach-related side effects like nausea, vomiting, diarrhea, and abdominal pain, which may feel worse if you already have diverticulitis. It may also increase the risk of complications, so any new or severe symptoms should be checked by a healthcare professional.

Some people with diverticulitis taking Ozempic can have an increased risk for:

• Worsening of gastrointestinal effects: Diverticulitis affects the digestive health, and Ozempic may worsen stomach-related symptoms. Seek medical advice if symptoms are severe or persistent.

• Increased risk of diverticulitis complications: Ozempic may increase the risk of complications such as bowel obstructions, abscesses, or perforations in people with diverticulitis. Watch for warning signs like severe pain or changes in symptoms and seek medical attention if symptoms worsen.

• Hypoglycemia: Ozempic lowers blood sugar levels, which may increase the risk of hypoglycemia in individuals with diverticulitis who are not diabetic. Watch for signs like dizziness, shakiness, sweating, or a fast heartbeat, and seek immediate medical help if these occur.

• Interactions with other medications: People with diverticulitis may take multiple medications that may interact with Ozempic. Certain medications, such as antibiotics, might interact with Ozempic and amplify its side effects. Always inform your healthcare provider about all the medications you are currently taking.

Does Ozempic cause diverticulitis?

Some patients have developed Trusted sourcePubMed Central (PMC)PubMed Central is the National Library of Medicine's free full-text archive of biomedical and life sciences journal literatureGo to source diverticulitis while taking Ozempic, but there’s no clear evidence that the medicine causes it. Clinical trials showed Trusted sourceDailyMedDailyMed is the National Library of Medicine's official provider of FDA drug labeling informationGo to source that people taking Ozempic were not more likely to get diverticulitis than those who didn’t. Novo Nordisk, the manufacturer of Ozempic, doesn’t list diverticulitis as a known side effect.

Researchers continue to track Ozempic’s safety in real-world use. As seen in current safety data Trusted sourcePubMedPubMed is a free database of biomedical literature citations and abstracts, maintained by the National Library of MedicineGo to source , there hasn’t been a clear link between Ozempic and diverticulitis.

Since only a small number Trusted sourcePubMedPubMed is a free database of biomedical literature citations and abstracts, maintained by the National Library of MedicineGo to source of Ozempic users have developed diverticulitis, it seems unlikely that Ozempic increases the risk of this condition.

The results of a large study of about 160,000 adults with type 2 diabetes taking Ozempic were compared to those of people on other diabetes medications, showing:

• For people who already had diverticulosis, Ozempic users were just as likely to develop diverticulitis as those on other medicines.

• For people without diverticular disease, Ozempic users were less likely to develop diverticulosis than those on other medications.

These results suggest that Ozempic does not directly cause diverticulitis. It may even help prevent diverticular disease in people who don’t have it yet, but it doesn’t seem to reduce the risk of a flare if diverticular disease is already present. More research is needed to confirm these findings.

Can you take Ozempic if you have a history of diverticulitis?

Many doctors agree that you can take Ozempic if you have diverticular disease or a history of diverticulitis, but it should be done with caution and close monitoring. However, this could change if future research shows a stronger link between Ozempic and these conditions.

Losing weight can lower pressure inside the abdomen and reduce overall inflammation, which may help protect against diverticular disease over time.

If you have a diverticulitis flare, your doctor may ask you to stop Ozempic until the inflammation goes away. After recovery, you may be able to safely restart the medication.

Can Ozempic trigger a diverticulitis flare?

Ozempic is unlikely to directly cause a diverticulitis flare. However, its side effects, like constipation and hard stools, can increase pressure in the colon, which may make a flare more likely in some people.

In rare cases, Ozempic can cause gastroparesis, a serious condition that leads to pain, bloating, nausea, and vomiting.

For people with diverticular disease, these symptoms can look like early signs of diverticulitis, making it hard to tell the difference. Constipation is also a concern, as it can increase pressure in the colon, but Ozempic-related constipation is usually temporary and hasn’t been linked to more diverticulitis flares.

While it is not strictly unsafe, people with a history of diverticulitis should be closely monitored by their healthcare provider when starting GLP-1 medicines like Ozempic.

Ozempic and diverticulitis: Symptoms comparison

Both can cause abdominal discomfort, but some signs can help you identify whether the symptoms are related to Ozempic or diverticulitis.

Managing the risks

If you have diverticular disease, you can take steps to reduce your chances of getting diverticulitis, including:

• Quit smoking (if you smoke)

• Consider weight loss if you have a body mass index of 30 or greater

• Increase physical activity

• Increase fiber in your diet

• Stay well hydrated

• Avoid nonsteroidal anti-inflammatory drugs (NSAIDs)

• Gradually increase the dose

Seek medical help right away if you think you have diverticulitis. Your doctor can start the proper treatment, and some people may need to stay in the hospital until the inflammation improves.

When to stop Ozempic and see a doctor

Seek help immediately if you:

• Can’t keep fluids down

• Have severe or constant abdominal pain

• Have a high fever (over 101°F)

• Have bloody stools

• Have trouble passing gas or stool

If you notice any of these, call your doctor right away. A gastroenterologist should be part of your care team if you have diverticulosis and are taking Ozempic. You should not stop Ozempic on your own. Your doctor may suggest a temporary pause until a flare is treated.

7 tips for managing diverticulosis while on Ozempic

If you have diverticulosis or a history of diverticulitis and are taking Ozempic, you may not need to stop the medication. Here are some tips to manage diverticulosis while on Ozempic safely:

1. Dietary modifications: Diet changes are important in managing diverticulitis and preventing flare-ups. Eating a high-fiber diet, including fruits, vegetables, whole grains, beans, and legumes, can help keep bowel movements regular. Choose gentle fiber foods like oats, apples, and psyllium husk. These are easier on the gut compared to very rough, raw high-fiber foods.

2. Prioritize hydration: Water works with fiber to prevent constipation caused by Ozempic. Drink plenty of water daily to stay hydrated and support better digestion.

3. Listen to your body: If you feel new abdominal pain, switch to a light or liquid diet for about 24 hours. This can help you see if it’s a temporary side effect or a possible flare.

4. Physical activity: Regular exercise can help manage diverticulitis and support overall health. Activities like walking, light jogging, or yoga can improve digestion, reduce stress, and help prevent constipation.

5. Eat small, frequent meals: Have smaller meals more often instead of large, heavy meals. This supports smoother digestion and is helpful for both Ozempic use and gut health.

6. Avoid NSAIDs for pain: Pain relievers like ibuprofen can irritate the gut and may increase flare risk. Paracetamol (acetaminophen) is usually a safer option, but always check with your doctor first.

7. Avoid straining during bowel movements: Straining during bowel movements can increase pressure in the gut and worsen diverticulitis symptoms. To avoid this, eat enough fiber, drink plenty of water, and stay relaxed. If needed, stool softeners may help. Ask your doctor before using them.

While Ozempic may be helpful, it is also good to consider other treatment options Trusted sourcePubMed Central (PMC)PubMed Central is the National Library of Medicine's free full-text archive of biomedical and life sciences journal literatureGo to source for diverticulitis. These options can support symptom control, but their effects may vary by person. Always talk to your doctor before making any changes to your treatment plan.

FAQs

Can Ozempic cause diverticulitis?

No, Ozempic does not cause diverticula to form. However, it can slow digestion and sometimes cause constipation, which may trigger inflammation in people who already have diverticula. It doesn’t create the condition but may worsen existing diverticular issues in some cases.

Should I take Ozempic if I have diverticulosis?

Yes, many people with diverticulosis take Ozempic safely. Just make sure to drink enough fluids, eat enough fiber, and watch for any new or worsening stomach symptoms.

My stomach hurts on Ozempic. Is it diverticulitis or just a side effect?

If the pain is sharp, mainly on the lower left side, and is accompanied by fever, it could be diverticulitis. If you feel nausea or mild stomach upset, it is more likely a common side effect of Ozempic. If you are unsure, it is best to see a doctor.

Will I have to stop Ozempic permanently after a diverticulitis flare?

No, you may not need to stop Ozempic permanently. After a diverticulitis flare heals with proper treatment and diet, you can resume Ozempic under your doctor’s guidance.

Can I restart Ozempic after a flare-up?

Yes, you can usually restart Ozempic after a flare-up once your symptoms have improved. However, do this only after getting medical attention from your doctor to make sure it is safe for you.

Does Wegovy have the same risks?

Yes, Wegovy has similar risks because it contains the same active ingredient, semaglutide, as Ozempic. This means it can also slow digestion and may cause stomach side effects like nausea or constipation. The overall risk of digestive issues is generally similar across the semaglutide family.

What foods should I eat to prevent issues with Ozempic?

Eat simple, bland foods like rice, bananas, toast, yogurt, and soups that are easy to digest. Choose foods with high water content, such as fruits, vegetables, and broths. Drink plenty of water and eat small, frequent meals instead of large portions. This can help prevent stomach discomfort and constipation while on Ozempic.

Conclusion

While Ozempic can affect digestion, there’s no clear evidence that it causes or worsens diverticulitis.

You can take Ozempic if you have a history of diverticular disease. However, the medication may cause stomach side effects that may feel like early signs of diverticulitis.

Taking Ozempic when you have diverticular disease requires careful monitoring by a medical provider, but it is manageable with the right guidance.

If you have diverticular disease and experience severe abdominal pain, fever, or other worrying symptoms while on Ozempic, see a doctor immediately.

Ozempic can help improve your health, but paying attention to your gut and knowing when to seek help is the most important step.