Semaglutide and the Aerodigestive System: Emerging Evidence and Monitoring Strategies
Over the last several years, research has shown a significant increase in semaglutide (Ukhanova et al., 2025). Semaglutides can provide many benefits such as glycemic control, chronic weight management, and reducing the risk of cardiovascular issues (Kommu & Whitfield, 2024; Shu et al., 2022).
Although semaglutide use can provide significant benefits, they may also result in adverse reactions. These events can include anatomical changes including gastric bezoars, thyroid masses, and esophageal foreign body impaction, as well as issues such as delayed gastric emptying, reduced absorption of medication taken concurrently, esophageal dysmotility, nausea, vomiting, abdominal pain, dysphagia, constipation, dehydration, dysgeusia, dyspepsia and diarrhea (Aijaz et al., 2024; Kommu & Whitfield, 2024; Ng et al., 2025; Sheth et al., 2024; Shu et al., 2022; Sun et al., 2015). Higher risk of adverse effects is associated with increased medication doses and dose escalations (Kommu & Whitfield, 2024). The most commonly occurring gastrointestinal adverse events secondary to semaglutide use include nausea, vomiting, and diarrhea (Nauck et al., 2013; Shu et al., 2022; Sun et al., 2015; ). These symptoms are hypothesized to be due to activation of the central and peripheral GLP-1 receptors and delayed gastric emptying caused by semaglutide use (Smits & Van Raalte, 2021).
It is important to note that semaglutide is approved by the US Food and Drug Administration (FDA) as 3 individual brand-name medications: Ozempic, Wegovy, and Rybelsus, and that each has its own indications, dosages, and considerations (Kommu & Whitfield, 2024). Healthcare teams should be aware of the benefits and risk of semaglutide use, and patients should be provided with proactive counseling pertaining to adverse effects and complications. Collaborative monitoring efforts by the healthcare team and patient are important to ensure adherence to the recommended dose and symptom identification focusing on events such as nausea, vomiting, diarrhea, constipation, dehydration, neck lumps, hoarseness, dyspnea, and dysphagia, among others, which can help facilitate early detection of issues.
To learn more about semaglutide use as well as risks and benefits, check out the references cited here.
