The People's Perspective on Medicine

Abdominal Obstruction Due To Lisinopril Is Life Threatening

Have you ever had a really bad bellyache? Such attacks can be hard to diagnose. If the BP drug lisinopril causes abdominal obstruction it can be deadly!
Man helping woman with a stomach pain

Bad bellyaches can be hard to diagnose. Is it gas, unusual heartburn, appendicitis or something especially challenging such as abdominal obstruction? This reader developed abdominal angioedema from the blood pressure drug lisinopril. It might have killed her.

What Caused Abdominal Obstruction?

Q. I honestly believe you saved my life. By chance I came across your syndicated newspaper column describing reactions to lisinopril. My jaw dropped!

I had been hospitalized at least eight times for “abdominal obstruction” and had two surgeries–one to remove my appendix which was found to be pink and healthy and the other for lysis of adhesions (none found).

I had been referred to specialists, scoped up and down and even went to a specialty clinic. Not one doctor, emergency room or hospital ever connected my symptoms to the lisinopril I was taking.

Since coming off lisinopril, I feel like a new person. I started feeling well again for the first time in years.

ACE Inhibitors and Abdominal Obstruction:

A. Lisinopril belongs to a class of “pril” blood pressure medications called ACE (angiotensin converting enzyme) inhibitors. While drugs like benazepril, captopril, enalapril and ramipril are quite effective, they do have some serious side effects.

One that can be life threatening is called angioedema. In this reaction, a person may find that lips, tongue and throat swell and can block breathing. Such swelling may also occur in the intestines.

Symptoms of Angioedema in the Digestive Tract:

Abdominal angioedema can be hard to diagnose because the symptoms might be mistaken for something else. The swelling can lead to severe stomach cramping, intestinal obstruction and vomiting.

Other readers who have experienced this reaction were initially diagnosed with things like stomach flu, allergies, Crohn’s disease and appendicitis. Here are some stories about angioedema from visitors to this website:

Joel also had difficulty with a diagnosis:

“I took lisinopril for about a month. I reacted badly to this drug. I felt like I was dying.

“My symptoms started out with an irregular heartbeat. I also experienced diarrhea, headaches, nausea, stomach pain and a burning sensation like someone took a blow torch to my guts. Eating is still difficult and seems to aggravate the situation.

“Since the whole thing began I have been in and out of ERs numerous times. I was hospitalized for a week. I had a colonoscopy, endoscopy, lots of blood work, as well as stool and urine samples.

“At first the doctors didn’t think it was the blood pressure medicine when I had brought it up. Since they couldn’t find anything else wrong, they said the probable cause was angioedema due to lisinopril medication.”

Alan’s experience was somewhat similar:

“After taking lisinopril for several years I developed bad stomach bloating. I was unable to eat large meals. I made a number of trips to my local clinic. The doctors assumed I had IBS [irritable bowel syndrome].

“I suffered with this condition for more than two years. It made me very anxious. I was constantly thinking about my stomach problems. I could no longer enjoy food the way I used to.

“I asked the doctor whether lisinopril could cause any of these symptoms, and he ruled that out.

“While I was on vacation this spring I had a really bad attack. It felt like my ribs were being crushed. I had pain in my back, a taste of metal in my mouth and pins and needles all over my body. I went to see the doctor and he blamed my symptoms on a panic attack.

“One other symptom developed since March. I had a burning sensation in my nose, lips and tongue. This was the final straw for me. I did an experiment where I just stopped taking the lisinopril. After three days I felt all the pains had gone except for the burning lips. I felt great but the only downside was that my blood pressure was creeping back up.

“I then took the lisinopril for one day, and the very next day I had all the pains back. I knew then that the lisinopril was the cause and was poisoning my body. I am now switching over to a beta blocker instead of an ace inhibitor. I am visiting a gastro doctor. Hopefully I haven’t had any lasting damage from this drug. Listen to your body!”

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Karen’s doctor still does not believe lisinopril could cause abdominal obstruction:

“I just had a terrible bout with lisinopril. I took it for three days. Each day the stomach pain got worse until it was absolutely excruciating. My intestines felt like they were on fire and they were so swollen I thought they would burst.

“I refused to go to the emergency room because I Googled it, and knew there was nothing they could do (except lots of unnecessary tests and possibly surgeries). I endured it, writhing in pain until it finally subsided after 36 hours.

“I reported this to my doctor so she could have a record and hopefully warn other patients about it. She said that since I didn’t go to the emergency room and she has never heard of this reaction, that it must be something else. I don’t take any other medications.

“I wouldn’t wish that pain on my worst enemy. Since doctors don’t seem to want to hear about it, I’m afraid more unsuspecting people might have to go through angioedema from drugs like lisinopril.”

Angioedema and Abdominal Obstruction:

Symptoms of angioedema can come on suddenly, as Karen described. Even more confusing, though, is a delayed reaction. Someone could take an ACE inhibitor like captopril or lisinopril for years without experiencing any side effects.

Then, out of the blue, a patient could develop swelling of the lips or tongue. Even more challenging, an abdominal blockage could occur because of swelling in the intestines. All such reactions must be treated as medical emergencies. We would have advised Karen to go to the emergency room. In some cases, surgery could save a life.

An article in the Journal of Pharmacy Practice (Feb. 2018) describes a case report where a woman developed abdominal blockage after two years on lisinopril. The authors write:

“Two days after discontinuation of the lisinopril, the patient reported improvement in symptoms.”

They go on to note that ACE inhibitors can trigger unique symptoms that could be hard to diagnose.

You can read about other such reactions at this link:

Lisinopril Side Effects Can Be Life Threatening: Beware Angioedema and ACE Inhibitors!

How To Avoid Life-Threatening Drug Reactions:

We have written more about problems with misdiagnoses and lisinopril side effects in our book, Top Screwups. We provide tips for avoiding all sorts of adverse drug reactions and offer concrete recommendations for avoiding medical errors.

Share your own story in the comment section.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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  • Wilin, K.L., et al, "ACE Inhibitor-Induced Angioedema of the Small Bowel: A Case Report and Review of the Literature," Journal of Pharmacy Practice (Feb. 2018), doi: 10.1177/0897190017690641
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I had been taking Lisinopril for years and developed a cough. My cardiologist dismissed it, saying the cough was probably allergies. The cough got worse and after reading your çolumn, I went back to my cardiologist and he switched me to benazepril. My cough didn’t improve. My daughter is a pharmacist, said it is a “pril” and go back to the cardiologist and he switched to losartan. It took almost 3 weeks but my cough gradually went away.

I never truly appreciated my good fortune regarding Lisinopril until I read your article and patients’ comments. Years ago, I was put on Lisinopril by an internal medicine doctor. After only a few days, I started experiencing tachycardia. I reported this as soon as it began occurring. The nurse spoke with the doctor, and I was told she wanted me to stop taking the Lisinopril immediately and not to take any more of it.

There are doctors who adamantly declare whatever is wrong, it can’t be the medicine causing it, so it must be the patient. I had a doctor who put me on the same medicine three different times. The third time I was unable to walk straight no matter how hard I tried, and when I stepped myself off the medicine, I felt like I had the flu for two to three weeks.

Other than my Lisinopril experience, I totally agree with Jane’s comments.

Oh my gosh. I’m taking lisinopril and about 8 months ago I started getting pain in my upper and lower GI tract. I am so bloated I can’t eat more than a couple of bites of my meal.
I am angry that no doctor or nurse or pharmacist mentioned any of these issues. I have been in pain for months and feel so weak like I have the flu.
Thank you for this valuable information. I am stopping the medication and calling my cardiologist.
You may have saved my life.

What I note, and am very disturbed by it, is that all of the stories in this article the medical “experts” immediately dismissed any possibility that the drug was the problem. I wonder why the preferred methodology seems to be “lets run a bunch of very expensive and invasive tests first and maybe if nothing is found consider it may be a drug reaction or… all in your head.”

I am continually put off by the hubris and narrow scope of big medicine. As for the “new guidelines” in the article below, I will not be convinced that if 150,000,000 people require drugs to meet the new standard it is a reasonable standard. It is however a very lucrative standard isn’t it?

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