S1093 Slowing Transit Without Consequence? Evaluating GLP-1 Agonist Use in Patients With IBS

Introduction: The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has increased significantly given their benefits in managing type 2 diabetes and obesity. GLP-1 RAs are known to delay gastric emptying and slow intestinal motility. While these effects are pharmacologically beneficial, it remains unclear whether they contribute to the development of gastrointestinal conditions or symptom exacerbation in patients with underlying motility disorders such as irritable bowel syndrome (IBS). This study aimed to evaluate whether GLP-1 RA use in patients with IBS is associated with higher rates of small intestinal bacterial overgrowth (SIBO), gastroparesis, and increased healthcare utilization including emergency department (ED) visits and hospital admissions. Methods: We performed a retrospective cohort study of adult patients (aged ≥18 years) diagnosed with IBS who were seen at a large tertiary care health system between January 1, 2021, and December 31, 2024. Patients were stratified into 2 groups based on the use of GLP-1 RAs. The primary outcomes were the incidence of SIBO and gastroparesis. Secondary outcomes included gastrointestinal-related ED visits and hospital admissions. Differences between groups were evaluated using chi-square analysis. Results: A total of 346 patients met inclusion criteria, with 173 in the GLP-1 RA group (141 women, 32 men) and 173 in the non-GLP-1 group (125 women, 48 men). SIBO was diagnosed in 6 patients (3.5%) in the GLP-1 group and 12 patients (6.9%) in the non-GLP-1 group (P = 0.23). Gastroparesis occurred in 10 (5.8%) GLP-1 users and 17 (9.8%) non-users (P = 0.23). ED visits related to gastrointestinal symptoms were reported in 17 (9.8%) GLP-1 users and 27 (15.6%) non-users (P = 0.15). Hospital admissions occurred in 18 (10.4%) patients in the GLP-1 group versus 15 (8.7%) in the non-GLP-1 group (P = 0.71). Conclusion: In patients with IBS, GLP-1 RA use was not associated with a statistically significant increase in the incidence of SIBO, gastroparesis, or gastrointestinal-related healthcare utilization. Despite their known effects on gastrointestinal motility, GLP-1 RAs did not appear to increase the burden of motility-related complications in this population. Further prospective studies are needed to evaluate long-term outcomes and assess potential subgroup differences.