Low Rates of Aborted Endoscopy Due to Gastric Food Retention in Patients on Glucagon-Like-Peptide-1 Receptor Agonists

Feb 28, 2025Digestive diseases and sciences

Low risk of canceled stomach exams from food leftover in patients taking GLP-1 medicines

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Abstract

Out of 32,275 upper endoscopic procedures, 0.1% were aborted due to retained gastric food in patients taking GLP-1 receptor agonists.

In total, 1179 procedures involved patients on GLP-1 receptor agonists.
Among the GLP-1 cohort, 0.6% of procedures were aborted due to gastric food retention.
In comparison, only 0.096% of procedures were aborted in the non-GLP-1 cohort (p < 0.01).
No aspiration events were reported in patients with retained food during endoscopy.
The increase in gastric food retention associated with GLP-1 RA use is minimal despite the higher rates observed.

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BACKGROUND: Glucagon-like peptide-1 receptor agonist (GLP-1 RA) use has dramatically increased with expanded indications for weight loss. Delayed gastric emptying due to these medications can lead to residual food in the stomach, which can increase the risk of periprocedural aspiration during endoscopic procedures. The aim of this study is to document rates of gastric food retention and aspiration events during upper endoscopy in patients on GLP-1 RA.

METHODS: A retrospective cohort study was performed including all patients who underwent upper endoscopic procedures at two hospitals during 2018-2023. Procedure abortion due to the presence of food was taken as primary study endpoint. The secondary endpoint was aspiration events in patients with food noted on endoscopy.

RESULTS: Out of a total of 32,275 total upper endoscopic procedures performed during the study period, 1179 procedures were performed in patients taking GLP-1 RAs (GLP-1 cohort). In total, 37 endoscopies (0.1%) were aborted due to retained gastric food; 7 patients (0.6%) in the GLP-1 cohort vs 30 patients (0.096%) in the non GLP-1 cohort (p < 0.01). There were no episodes of aspiration in patients with retained food.

CONCLUSIONS: In a large retrospective cohort, GLP-1 RA use did increase rates of gastric food retention during upper endoscopy, though the absolute risk was minimal. There were no aspiration events related to gastric food retention. Because of the small number of events, there were no clear modifiable risk factors for gastric food retention. This study supports the practice of individualized periprocedural management in patients on GLP-1 RA.

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Low Rates of Aborted Endoscopy Due to Gastric Food Retention in Patients on Glucagon-Like-Peptide-1 Receptor Agonists

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