Risk of Ileus with Tirzepatide Use

Gastrointestinal Side Effects of Tirzepatide

Tirzepatide, as a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, is associated with significant gastrointestinal adverse effects, including nausea, vomiting, diarrhea, and esophageal reflux, according to the American Diabetes Association 1, 3
Constipation is specifically listed as one of the gastrointestinal adverse events that can occur with tirzepatide use, as reported by the American Diabetes Association 3

GLP-1 receptor activation delays gastric emptying by inhibiting gastric peristalsis while increasing pyloric tone, as explained by the American Society of Anesthesiologists 4
This effect is mediated through the vagus nerve, as GLP-1 receptors located on the myenteric plexus activate pathways that inhibit vagal activity on the gut, according to the American Society of Anesthesiologists 5
The dual action of tirzepatide on both GLP-1 and GIP receptors may contribute to its pronounced effects on gastrointestinal motility, as reported by the American Society of Anesthesiologists 4

Healthcare providers should monitor for potential consequences of delayed absorption of oral medications in patients taking tirzepatide, as recommended by the American Diabetes Association 3
Patients with pre-existing gastrointestinal motility disorders may be at higher risk for developing ileus, according to the American Society of Anesthesiologists 5

There is concern about increased risk of pulmonary aspiration during anesthesia in patients taking GLP-1 receptor agonists due to delayed gastric emptying, as reported by the American Society of Anesthesiologists 6, 7
Consideration should be given to the timing of tirzepatide administration in relation to surgical procedures requiring general anesthesia, as recommended by the American Society of Anesthesiologists 6