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Key warning signs of possible colitis include: Persistent or bloody diarrhea While diarrhea is a known semaglutide side effect, the presence of blood, mucus, or pus in stool suggests inflammatory or ischemic colitis and requires immediate medical evaluation Severe abdominal cramping Intense, persistent cramping pain, particularly in the lower abdomen, that differs from mild discomfort associated with typical medication side effects Urgent bowel movements Sudden, uncontrollable urges to defecate, especially if accompanied by inability to empty the bowel completely (tenesmus) Fever and systemic symptoms Elevated temperature, chills, fatigue, or malaise accompanying gastrointestinal symptoms may indicate inflammatory processes Unintended weight loss Progressive weight loss out of proportion to expected therapeutic effects, particularly when accompanied by decreased appetite and nutritional deficiencies Severe constipation or abdominal distension Inability to pass stool or gas, abdominal bloating, or vomiting may indicate ileus or intestinal obstruction requiring urgent evaluation Distinguishing between common semaglutide-related gastrointestinal effects and potential colitis requires attention to symptom severity, duration, and progression

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