CureusFeb 16, 2026

Ischemic Colitis Linked to Tirzepatide Treatment in a Young Woman: A Case Report

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Feb 17, 2026

Abstract

A case of ischemic colitis was identified in a 32-year-old woman after six weeks of tirzepatide therapy for weight loss.

The patient experienced hematochezia and abdominal pain, leading to further investigation.
Laboratory tests indicated neutrophilic leukocytosis without signs of anemia or electrolyte issues.
Colonoscopy revealed patchy erosions and ulcerations in the sigmoid and descending colon.
Biopsy confirmed the diagnosis of ischemic colitis, despite the absence of typical causes.
The association between glucagon-like peptide-1 receptor agonists and ischemic colitis has been suggested in recent reports.
This case highlights the need for clinicians to be aware of potential gastrointestinal complications related to incretin-based therapies.

Simplified

Tirzepatide has been approved for the management of obesity, obstructive sleep apnea, and type 2 diabetes mellitus; while gastrointestinal side effects are commonly seen, ischemic colitis has been only rarely described. We present the case of a 32-year-old woman with no prior medical history who developed hematochezia and abdominal pain after six weeks of tirzepatide therapy for weight loss. Laboratory evaluation showed neutrophilic leukocytosis without anemia or electrolyte abnormalities, and stool studies were negative for infection. A CT of the abdomen and pelvis excluded obstruction or wall thickening but incidentally revealed hepatic steatosis and adnexal lesions. Colonoscopy demonstrated patchy erosions, erythema, and ulcerations in the sigmoid and descending colon, with biopsy confirming ischemic colitis. She was managed conservatively with bowel rest, intravenous fluids, and close monitoring, with stable hemoglobin and complete resolution of symptoms. Although ischemic colitis is more typically linked to vascular disease, hypotension, or vasoconstrictive drugs, recent reports have suggested an association with glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide and tirzepatide. The temporal relationship with tirzepatide initiation, absence of infection, and confirmatory histology strongly support drug-induced ischemia in this case, underscoring the importance of clinician awareness of this rare but significant complication in patients presenting with rectal bleeding or abdominal pain while on incretin-based therapy.

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Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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Ischemic Colitis Linked to Tirzepatide Treatment in a Young Woman: A Case Report

Abstract

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