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The clinical manifestations and severity of ileus present as: Complete inability to pass gas or have bowel movements, distinguishing it from simple constipation Severe abdominal distension causing visible swelling and extreme discomfort Intractable nausea and vomiting, including feculent vomiting in advanced cases Severe cramping and abdominal pain that worsens with attempted eating Dehydration and electrolyte imbalances from inability to absorb fluids Risk of intestinal perforation if pressure builds excessively Potential progression to sepsis and multi-organ failure without prompt treatment Need for nasogastric decompression, bowel rest, and potential surgical intervention The mechanism by which Ozempic causes ileus directly relates to its intended therapeutic action of slowing gastrointestinal motility, but in susceptible individuals, this effect becomes pathologically exaggerated