Olmesartan: A Little-Known Cause of Diarrhoea

Olmesartan’s sprue-like enteropathy was first described in 2012 and typically presents with diarrhoea, weight loss, nausea, vomiting, low albumin and histological evidence of intestinal villous atrophy. Coeliac disease is one of the main differential diagnoses and should be excluded. We present the clinical case of a 63-year-old man treated with olmesartan for 10 years who presented with a 2-month history of diarrhoea and was diagnosed with olmesartan’s enteropathy. This case highlights the need for clinical suspicion of this new entity in order to reduce the associated morbidity and unnecessary costly investigations. LEARNING POINTS: Sprue-like enteropathy associated with olmesartan is a recently described and recognized disease. This condition should be suspected in patients taking olmesartan who have chronic diarrhoea, intestinal villous atrophy and negative serology for coeliac disease, or an absent response to a gluten-free diet. Early suspicion of olmesartan’s enteropathy can reduce the associated morbidity and avoid costly investigation.