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Mounjaro and IBS: What Impact Would Tirzepatide Have on My Gut?

Mounjaro and IBS

Mounjaro, also known as Tirzepatide, is a powerful medicine commonly used to treat diabetes. Its main action involves changing the gut hormones in the body.

However, individuals with Irritable Bowel Syndrome (IBS) might feel hesitant and concerned about using Mounjaro due to its notable gastrointestinal (GI) side effects.

People with IBS have a heightened sensitivity to certain foods and medications that can influence their gut hormones. Therefore, it is crucial to carefully monitor how Mounjaro affects their symptoms if they also have IBS.


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We collected data from 26 patients with IBS who tried Mounjaro. Reviews of the patients are given at the end of the article.

Here is a table summarizing the results:

Impact of Mounjaro on the symptoms of IBS
Symptoms of IBS Improved23 (88.5%)
IBS Symptoms Worsened2 (7.7%)
Developed IBS-D1 (3.8%)

What are the symptoms of IBS (Irritable bowel syndrome)?

IBS (Irritable bowel syndrome) is a very common medical condition. It has three subtypes:

  • IBS-D
  • IBS-C
  • IBS-M

IBS-D is irritable bowel syndrome with predominant diarrhea, IBS-C is IBS with predominant symptoms of constipation, and IBS-M is IBS with mixed or alternating symptoms of diarrhea and constipation.

Apart from diarrhea and constipation, individuals with IBS have other symptoms which may be more disturbing at times than diarrhea or constipation. These include:

  • Bloating and abdominal gases
  • Abdominal pain and cramping
  • Urgency and the feeling of incomplete gut emptying after defecation
  • Nausea and anorexia
  • Anxiety, palpitations, and disturbed sleep.

Why some people are more prone to develop IBS than others?

IBS, or Irritable Bowel Syndrome, is characterized by heightened sensitivity and irritability in the gut.

Just like a person who gets easily annoyed, the gut can also become easily irritated in individuals with IBS.

People with IBS are highly sensitive to even minor changes in their diet, surroundings, mood, and overall health.

As a result, they can experience intense abdominal pain, bloating, or diarrhea simply from tasting or smelling certain foods.

They may develop a lingering unpleasant taste and aversion to specific foods that can persist for months.

Moreover, these abdominal symptoms are often accompanied by feelings of anxiety and depression.

The exact cause of IBS is not fully understood, but many studies suggest that the gut-brain axis plays a central role.

IBS can be seen as a form of anxiety, where multiple factors affect gut health, with serotonin being a likely major contributor.

Here are some factors that influence the gut and are believed to contribute to the development of IBS:

  • Changes in Gut Motility:

Altered gut motility can cause different bowel movement patterns. Increased gut motility can lead to diarrhea, while reduced gut motility can result in constipation.

  • Heightened Sensitivity in the Gut:

When the gut is highly sensitive, it can contract more forcefully than usual, causing spasms and abdominal pain.

  • Intestinal Inflammation:

Unlike inflammatory bowel diseases (IBDs), IBS does not typically involve significant inflammation. However, some studies suggest that low-grade inflammation may play a role in the development of IBS.

  • Bacterial Overgrowth or a Change in Gut Flora:

Certain studies propose that bacterial overgrowth or changes in the gut’s microbial composition may contribute to IBS symptoms.

The effectiveness of Rifaximin, a gut antiseptic, in improving symptoms further supports this idea.

  • Gut-Brain Axis and Psychosocial Factors:

Dysfunction in the communication between the brain and the gut plays a role in IBS. This interaction is influenced by psychosocial factors, resulting in the development of IBS symptoms.

How does Mounjaro affect the gut?

Mounjaro causes slowing of the stomach movements. This leads to stomach fullness as food can not pass into the small intestine to get absorbed.

Thus, Mounjaro users frequently have symptoms of nausea, abdominal fullness, burping, and loss of appetite.

In addition, it also impairs the absorption of food and acts centrally on the neurotransmitters that affect gut peristalsis, visceral pain, and appetite.

In clinical trials, Mounjaro resulted in the following GI side effects:

The following gastrointestinal side effects were the most common:

Side effects

Mounjaro 5 mg(%)Mounjaro 10 mg(%)Mounjaro 15 mg(%)

Placebo

(%)

Nausea1215184
Diarrhea1213179
Loss of appetite510111
Vomiting5592
Constipation6671
Dyspepsia8853
Abdominal pain6554

The above adverse reactions occurred in at least 5% of the Mounjaro-treated patients.

Other commonly reported GI side effects that occurred in less than 5% of the treated patients include the following:

Side effects

Mounjaro 5 mg(%)Mounjaro 10 mg(%)Mounjaro 15 mg(%)

Placebo

(%)

Eructation32.53.30.4
Flatulence1.32.52.90
GERD1.72.5170.4
Abdominal distension0.42.90.80.4

More patients in the treatment group opted out of the trial because of gastrointestinal side effects.

Compared to placebo (0.4%), 3% of patients in the Mounjaro 5 mg group, 5.4% in the 10 mg group, and 6.6% in the 15 groups opted out of the trial because of GI-related side effects.

What effects can Mounjaro have on IBS? 

Based on the above GI effects of Mounjaro, Mounjaro can affect the gut in many ways.

Theoretically, it may worsen the symptoms of diarrhea in patients with IBS-D, causing bloating, fullness, and abdominal pain.

However, since some patients in the clinical trials also developed constipation, patients with IBS-D may improve if their gut movements are reduced as a result of Mounjaro.

This is also the case in patients with IBS-D and IBS-M. One can not predict based on the results of the clinical trials unless patients with IBS are enrolled and tried with Mounjaro.

To see how people with IBS have responded to Mounjaro, we collected data from social media. The results and their comments are published here:

What experiences have individuals with IBS had while using Mounjaro?

Theoretically, as discussed above, people with IBS will react differently to Mounjaro than most normal people. This is especially true for the gut-related symptoms of IBS.

Here are some of the patients’ reviews and experiences shared on social media of patients with IBS who were taking Mounjaro:

Mounjaro and IBS – a positive experience 👍:

I understand that it can be nerve-wracking to share this, but I recently started taking Mounjaro for my IBS-D, and I’m curious if others have experienced a calming effect on their stomach while on this medication.My doctor and I were both cautious and a bit worried about starting this treatment, considering how severe my stomach issues can be.I even made jokes like, “How much worse could it be?” or “Maybe I’ll end up with constipation as a side effect.” However, we agreed that it was worth trying to get my weight on the right track.Since I took my first dose, I’ve noticed that my stomach seems to be behaving more normally, and I’m wondering if anyone else has had a similar experience.

Mounjaro and IBS: Reduced Flares 👍:

I’ve been using Mounjaro for six weeks, and it has made a remarkable difference in managing my IBS. I’ve only had two instances where my IBS symptoms flared up, which is incredible considering I used to experience episodes three times a day, even on better days. This improvement is my favorite change, even more than the weight loss aspect.I genuinely hope that I can continue taking a low dosage of Mounjaro in the long run. It’s uncomfortable and disruptive to have to abruptly stop in the middle of a sentence at work just to rush to the bathroom. This used to happen to me frequently, but it has significantly reduced since starting the medication.

Mounjaro and IBS: IBS-D improved but now I have IBS-C 🤷‍♀️:

I’ve been dealing with IBS-D for two decades, but the past four months have brought about a remarkable transformation after I started Mounjaro.Instead of experiencing diarrhea three times a day as I used to, it has now decreased to just three instances in total. However, I’m currently facing the challenge of constipation.

Mounjaro is a blessing for me!

Since starting Mounjaro over a month ago, my IBS symptoms have practically vanished. I can’t express how happy and relieved I am. Previously, I had frequent instances where I had to rush to the bathroom, often barely making it in time or not at all. This medication feels like a true blessing for my IBS. I genuinely hope that I can continue taking it in the long term. It’s been years since I felt this joyful and content with my gut health.

I miss Mounjaro!

It has been three months since I stopped taking it. Within a span of about 2-3 weeks after discontinuing the medication, my stomach returned to its previous state. I find myself missing it tremendously.

I have good bladder and bowel control!

I really hope that I can continue using this medication, and that its benefits won’t be limited to just diabetes and weight loss (which, of course, are amazing outcomes!). It has been an overall game-changer for me, providing immense relief. I haven’t felt this good in years. Interestingly, I also used to struggle with bladder control, but now I’m experiencing significantly fewer issues in that area as well. I have dealt with both IBS and bladder problems for as long as I can remember, so this positive transformation has had a tremendous impact on my life. I genuinely feel like I can’t afford to lose access to this medication now.

IBS-D here: Wonderful experience with Mounjaro

As someone with IBS-D, I had concerns about experiencing constipation when starting this medication.To prepare, I made sure to consume some fiber the day before and on the day of my first injection.Unfortunately, I ended up having diarrhea for three days. However, since then, my experience has been wonderful.Mounjaro (MJ) has significantly reduced inflammation, and my digestion has been consistently fantastic ever since.

Struggled with SIBO but Mounjaro helped a lot:

As someone who struggles with SIBO/IBS, I have found that this medication has provided significant relief for some of my gastrointestinal issues. By limiting my food intake and eliminating many of the foods that used to aggravate my stomach, I have experienced a great improvement in my symptoms. It has been instrumental in helping me manage and alleviate the challenges I face due to SIBO/IBS.

I spaced my shots because of GI side effects:

After completing my 10th shot of Mounjaro, I have been experiencing ongoing gastrointestinal issues.However, I have noticed that spacing out my shots and extending the duration between doses to 9 days, it appears to alleviate some of these problems.

I now have regular bowels, thanks Mounjaro:

I wasn’t diagnosed with IBS, but I frequently experienced significant stomach issues. However, since starting Mounjaro, my condition has improved tremendously. While it may cause constipation for some individuals, it has actually regulated my bowel movements and made them more normal. I initially began with a dosage of 5 and have gradually increased it to 7.5. To ensure regularity, I even purchased prunes last week to aid in maintaining a healthy digestive flow.

Miraculous improvement in symptoms of IBD with Mounjaro:

Having longstanding IBD, I have experienced a miraculous improvement in my condition with the use of this medication.It has effectively slowed down my gastrointestinal transit time and significantly reduced inflammation.The positive impact on my digestive system has been remarkable, providing much-needed relief from the symptoms associated with my longstanding IBD.

Experienced severe diarrhea – Discontinued Mounjaro:

I have been taking Mounjaro for my IBS since September, starting at a dosage of 10. Unfortunately, I have been experiencing severe diarrhea and stomach pain that has been distressing and unbearable. At this point, I have decided to discontinue the medication. Despite being only 9 pounds away from my weight loss goal, the exhaustion and overall feeling of being unwell have become too much to bear. Prioritizing my well-being and seeking alternative solutions is now my focus.

Remarkable improvement of IBS symptoms with Mounjaro:

I have lived with IBSD for my entire life and have undergone extensive examination and tried numerous treatments under the guidance of a GI specialist. Unfortunately, my colon appears to be typical and does not show any specific abnormalities.However, I recently started taking Mounjaro as a weight loss aid, and to my surprise, it has had a profound impact on my IBS symptoms.In addition to its effectiveness in helping me achieve my weight loss goals, it has nearly cured my IBS.I now experience only one bowel movement per day, which is truly remarkable. While I’m unsure of the exact mechanism behind this additional benefit, I am incredibly grateful for the positive effects it has had on my overall well-being.

Mounjaro improved my IBS symptoms:

I had IBS-D and being treated with antidepressants that resulted in weight gain and without much relief of the GI symptoms.Despite following dietary restrictions, I still experienced cramping and monthly flare-ups. I was advised Mounjaro but my doctor was also worried about my IBS symptoms, however, the drug was a game-changer. Since starting the medication, I feel like a normal person again, with reduced bloating, improved bowel movements, and decreased pain. 

I don’t believe it:

I don’t believe, my IBS symptoms resolved with only 2.5 mg Mounjaro

Mounjaro made me feel normal: I had IBS-M:

I have mixed IBS symptoms with both diarrhea and constipation, but for the first time in my life, Mounjaro made me feel normal. Since stopping the medication on 11/29, my IBS symptoms have returned and are causing me trouble.

Amazing experience with Mounjaro:

For the past 4 months, while taking Mounjaro, I have had no IBS symptoms whatsoever. However, I have noticed that the day before my scheduled shot on the 6th day, my symptoms come back strongly.Once I take my shot on the 7th day, the symptoms disappear again until day 6. It’s worth noting that I have made no changes to my diet since starting Mounjaro. The impact it has had on my symptoms is genuinely incredible!

Mounjaro helped, but metformin worsened my symptoms:

Unfortunately, I had to stop taking Mounjaro due to changes in my insurance coverage, and my IBS has returned to its previous state. It’s incredibly frustrating and anger-inducing. To meet the new insurance requirements, I’m currently trying metformin for 90 days, but it has actually made my IBS worse, and I find it difficult to tolerate. The worst part is knowing that I have to wait 90 days before I can access insurance coverage for Mounjaro again. It’s truly disheartening to experience a sense of normalcy, only to have it taken away.

IBS-D improved:

I had IBS-D-like diarrhea but it’s solid now.

I don’t want to give up Mounjaro:

I’ve been taking Mounjaro for the past month, and let me tell you, it has been a life-changing experience. I’m going to miss it dearly, but it seems like I won’t be able to afford it anymore because I’m not diagnosed with type 2 diabetes.Seriously though, over the past month, I’ve only had one episode of IBS-D. My life was no longer controlled by constant worries of finding a bathroom or dealing with cramps and bloating every time I ate. I had regular bowel movements, no surprises, and I felt normal. It was absolutely glorious.Having experienced this newfound normalcy, I’m finding it difficult to let go. I really don’t want to give up Mounjaro. It’s disheartening to think about it.

Mounjaro really helped my IBS:

In addition to its benefits for my IBS, Mounjaro also helped lower my cholesterol levels. However, I haven’t been able to obtain it recently, and as a result, my IBS symptoms have returned.It’s truly unfortunate that it’s become so challenging to access the medication. I’m hoping that my prescription can be filled soon so that I can regain the relief it provided.

Mounjaro and IBS: Excellent drug:

I was given a month’s supply of Mounjaro by my doctor, and it made a remarkable difference in my IBS symptoms. Unfortunately, I faced difficulties getting a refill because I didn’t have a diabetic diagnosis, even though I was very close to meeting the requirements. For three months, I experienced relief and felt almost normal. However, now I’m back to struggling with symptoms, and it’s been a challenging battle for my system. I have even been bedridden for a couple of days to recover. I believe that in the future, this issue will receive attention, and I hope to qualify for the medication.

My IBS symptoms have disappeared:

I am thrilled to share that my IBS has completely disappeared! I have been dealing with bloating, frequent bathroom visits, and the constant worry of not making it in time for so many years.Since starting Mounjaro, my IBS symptoms have vanished, and I feel incredibly better.Not only has my physical health improved, but my depression has also lifted. The bloating is gone, and I have even lost weight. Additionally, I used to struggle with bladder problems, but they have improved by 99%.I truly hope and pray that this medication becomes approved for other conditions as well. It has been the best thing that has ever happened to me.

Mounjaro is life-changing:

I also suffered from both IBS and interstitial cystitis, which made my life incredibly challenging. Having to go to the bathroom frequently, especially during road trips and flights, was extremely embarrassing and inconvenient. I even restricted my water intake just to avoid frequent bathroom breaks. However, since starting Mounjaro, both my IBS and interstitial cystitis have been completely cured. I finally feel like a normal person again, free from the constant urge and discomfort. It’s truly life-changing!

I am grateful to Mounjaro:

Being prescribed this medication for diabetes has truly been life-changing for me.Although I haven’t experienced significant weight loss like many others, I am absolutely thrilled because it has resolved so many other health issues, including my IBS.The positive impact it has had on my overall well-being far outweighs any concern about weight loss. I’m grateful for the positive changes it has brought to my life.

Mounjaro is incredible:

Mounjaro has had an incredible effect on my IBS-D as well. It’s been a game-changer. However, I share your concern about the cost. The current coupon is only valid until June, and the monthly price is simply unaffordable for me at $1,000. It’s essential that we find a way to get this medication approved specifically for treating IBS.

In conclusion:

Mounjaro is a highly potent diabetes drug. It has not been studied in patients with IBS. Since most of the side effects of Mounjaro are related to the GI tract, people with IBS who are prescribed Mounjaro are apprehensive of the side effects.

Therefore, we collected data and reviews from IBS patients on social media and found that the drug helped most patients with IBS.

Out of a total of 26 patient reviews, two patients developed worsening of IBS symptoms, 1 patient with IBS-D developed constipation and 23 patients had a wonderful experience using Mounjaro.

Some patients even recommended Mounjaro as a treatment for IBS because of significant relief in their GI side effects.

Increasing awareness among healthcare professionals and advocating for its recognition as an effective IBS medication might be key. We need more support and options to make it accessible for those who truly benefit from it.


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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

Here is a link to My Facebook Page. You can also contact me by email at contact@dibesity.com or at My Twitter Account
You can also contact me via WhatsApp 🙏

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