Lisinopril and gastrointestinal side effects
Pro Research Analysisby 
Searched over 200M research papers
Lisinopril and Gastrointestinal Side Effects
Lisinopril-Induced Small Bowel Angioedema: Symptoms and Diagnosis
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used for hypertension and cardiovascular conditions. While angioedema is a known side effect of ACE inhibitors, it most commonly affects the face, lips, and upper airways. However, several reports highlight that lisinopril can also cause isolated small bowel angioedema, a rare but important gastrointestinal side effect. Patients typically present with acute or recurrent abdominal pain, nausea, vomiting, and sometimes diarrhea. These symptoms can occur within hours of the first dose or even years after starting the medication, making diagnosis challenging 1345678.
Imaging, such as CT scans, often reveals bowel wall thickening, submucosal edema, and sometimes ascites, which can mimic other conditions like inflammatory bowel disease or infections. Laboratory tests are usually unremarkable, and endoscopic evaluations often do not show specific findings. The key to diagnosis is recognizing the temporal relationship between lisinopril use and symptom onset, as symptoms typically resolve rapidly after discontinuing the drug 1345678.
Sprue-Like Enteropathy and Lisinopril
Although sprue-like enteropathy is more commonly associated with angiotensin II receptor blockers (ARBs) like olmesartan, rare cases have been reported with lisinopril. Patients may experience chronic diarrhea, weight loss, and villous blunting on biopsy, which can be mistaken for celiac disease. In these cases, symptoms do not improve with a gluten-free diet but resolve after stopping lisinopril, further supporting a drug-induced cause .
Lisinopril and Acute Pancreatitis
Lisinopril has also been rarely implicated in cases of acute pancreatitis. The proposed mechanisms include bradykinin-induced ductal obstruction and dysregulation of pancreatic enzymes. While this is an uncommon side effect, it should be considered in patients with unexplained pancreatitis, especially when other common causes have been ruled out and there is a temporal association with lisinopril use .
Clinical Implications and Management
Lisinopril-induced gastrointestinal side effects, particularly small bowel angioedema, are rare and often under-recognized. Symptoms can mimic other gastrointestinal disorders, leading to unnecessary investigations and interventions. Early recognition and discontinuation of lisinopril typically result in rapid symptom resolution. Clinicians should maintain a high index of suspicion for drug-induced causes in patients presenting with unexplained abdominal symptoms who are taking ACE inhibitors 13456782+1 MORE.
Conclusion
Lisinopril can cause rare but significant gastrointestinal side effects, including small bowel angioedema, sprue-like enteropathy, and, less commonly, acute pancreatitis. Awareness of these potential adverse effects is crucial for timely diagnosis and management, helping to avoid unnecessary procedures and improve patient outcomes. Discontinuation of lisinopril is the mainstay of treatment, with most patients experiencing complete resolution of symptoms.
Sources and full results
Most relevant research papers on this topic