How GLP-1 Medications Are Shaping the Role of Anorectal Manometry in GI Care

As GLP-1 receptor agonists like Ozempic®, Wegovy®, and Mounjaro® become increasingly common in both diabetes and weight loss management, a new clinical challenge is emerging: patients are reporting gastrointestinal symptoms that are difficult to differentiate from underlying disorders. For gastroenterologists and colorectal specialists, anorectal manometry (ARM) is becoming a crucial tool to evaluate and manage these symptoms with greater precision.

The GLP-1 Effect on GI Function

GLP-1 receptor agonists work by slowing gastric emptying, suppressing appetite, and improving glycemic control. However, these effects on motility are not limited to the upper GI tract. Clinicians are seeing a surge in reports of constipation, bloating, fecal urgency or incontinence, and incomplete evacuation.

While these side effects are documented, the challenge lies in determining whether the symptoms stem from the medication itself or reveal a previously undiagnosed functional disorder.

Why ARM Matters in the Context of GLP-1 Use

Anorectal manometry provides objective measurements of rectal sensation, sphincter function, and pelvic floor coordination. When used in patients experiencing lower GI symptoms while taking GLP-1 medications, ARM allows clinicians to:

• Differentiate between drug-related motility effects and true pelvic floor dysfunction

• Quantify the severity of anorectal dysfunction to support diagnosis and treatment planning

• Establish a baseline prior to initiating biofeedback or behavioral therapy

• Monitor progress if conservative management is pursued

Application

1. Persistent Constipation in GLP-1 Users
   ARM can determine if dyssynergic defecation is contributing to delayed evacuation, guiding appropriate therapy beyond simply adjusting medication.

2. New-Onset Incontinence
   For patients with sphincter weakness or rectal hypersensitivity, ARM can validate the diagnosis and support coverage for further interventions.

3. Pre- and Post-Treatment Evaluation
   Conducting ARM before initiating GLP-1 therapy in patients with a history of functional GI issues can provide a valuable baseline. If symptoms worsen, clinicians can compare data to determine causality.

A Growing Patient Population, A Growing Diagnostic Need

With the rapid expansion of GLP-1 usage across multiple patient demographics, gastroenterology practices are likely to encounter more cases of treatment-related GI symptoms. Relying on subjective symptom reports alone may lead to misdiagnosis or ineffective care. Adding ARM to your clinic’s diagnostic capabilities ensures you have the functional data necessary to avoid unnecessary medication changes, provide targeted, effective therapy, and deliver better patient outcomes with greater diagnostic confidence.

Conclusion

As the landscape of metabolic and obesity treatment evolves, so too must our diagnostic strategies. ARM, especially with tools like mcompass®, offers a non-invasive, objective way to assess lower GI function and differentiate between side effects and structural dysfunction. For clinics treating patients on GLP-1 medications, incorporating ARM into your evaluation process is not just helpful—it's essential.

Want to learn how mcompass® can support your diagnostic approach? Contact us today to schedule a free consultation or explore our clinical resources.