Benicar EnteropathyBenicar (olmesartan) is a prescription medication to lower blood-pressure that has been linked to at least 23 cases of sprue-like enteropathy. This gastrointestinal disease causes chronic diarrhea, weight-loss, nausea, vomiting, and more.

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Studies Linking Benicar and Enteropathy

One of the first studies linking Benicar and enteropathy was published in August 2012 by Mayo Clinic Proceedings. From 2008-2011, the Mayo Clinic in Rochester, Minnesota evaluated 22 patients with unexplained chronic diarrhea, weight loss, and enteropathy while taking Benicar. Many cases were severe — 64% were hospitalized and 15 patients had mucosal inflammation or other signs of intestinal damage. After discontinuing Benicar, all of the patients improved.

More recently, a study published in January 2014 by Digestive and Liver Disease described five cases of Benicar enteropathy. Researchers warned “all cases were observed in a small gastroenterology unit, which suggests that this adverse effect may not be rare.”

What is Enteropathy?

Sprue-like enteropathy is a disease of the intestine, also sometimes known as enteritis (inflammation of the intestine) or gastroenteritis if it also involves the stomach. The disease is characterized by chronic diarrhea, weight-loss, and inflammation of the intestines.

Signs & Symptoms

Symptoms of sprue-like enteropathy can occur months or even years after a patient starts taking Benicar. These symptoms may include:

  • Chronic diarrhea
  • Severe weight-loss
  • Nausea and vomiting
  • Dehydration
  • Malnutrition
  • Colitis (colon inflammation and swelling)
  • Intestinal damage
  • Subepithelial collagen villous atrophy
  • Mucosal inflammation
  • Collagen deposition (collagenous sprue)
  • And more

Diagnosis of Sprue-Like Enteropathy

The symptoms of sprue-like enteropathy mimic Celiac disease (gluten-sensitive enteropathy). Doctors should rule out Celiac disease by putting the patient on a gluten-free diet and using blood tests for tissue transglutaminase antibodies. If these tests rule out Celiac disease and other etiologies, Benicar should be discontinued and another anti-hypertension drug started.

Villous Atrophy

Intestinal villous atrophy is a complication of chronic diarrhea that causes permanent intestinal damage. It occurs when villi — the microscopic, finger-like tentacles that line the wall of the intestines — erode away, leaving a flat surface. Enteropathy also damages the mucous lining of the intestines. This causes problems with digestion and absorption of nutrients and food.

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