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.
