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Specific concerns for Crohn's patients include: Nausea and vomiting : May exacerbate existing symptoms or lead to dehydration, particularly concerning in patients with active disease Diarrhea : Difficult to differentiate from Crohn's-related diarrhea, potentially delaying recognition of disease flares Abdominal pain : May mask or mimic Crohn's-related pain, complicating clinical assessment Reduced oral intake : Appetite suppression combined with nausea may worsen nutritional deficiencies common in IBD Additional FDA-labeled risks include: Acute gallbladder disease : Cholelithiasis and cholecystitis occur more frequently with semaglutide, particularly with rapid weight loss [12] [15] Acute kidney injury : Dehydration from gastrointestinal side effects may lead to kidney injury Pancreatitis : Patients should be monitored for severe, persistent abdominal pain, sometimes radiating to the back Rare but serious gastrointestinal adverse events reported in post-marketing surveillance include cases of bowel obstruction and ileus