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GLP-1 Receptor Agonists May Interfere with Endoscopic Procedures

• GLP-1 receptor agonists like Ozempic and Wegovy may increase the risk of inadequate bowel preparation during endoscopy and colonoscopy. • A study in JAMA Network Open found a higher prevalence of food residue in the stomach and stool in the bowel among patients taking GLP-1 medications. • The increased risk could lead to missed lesions, patient dissatisfaction, procedure cancellation, and wasted resources. • Researchers suggest further studies are needed to determine if updated guidelines regarding GLP-1 use before endoscopies are necessary.

Patients using GLP-1 receptor agonists such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) may face increased challenges during endoscopic procedures due to delayed gastric emptying and constipation, according to a recent study published in JAMA Network Open. The research indicates that these medications can lead to inadequate bowel preparation, potentially hindering the clarity and effectiveness of endoscopies and colonoscopies.

Impact on Endoscopic Clarity

Led by Dr. Ruchi Mathur from Cedars-Sinai, the study involved 209 overweight or obese patients with a mean BMI of 34 and an average age of 63. Among them, 70 were taking a GLP-1 receptor agonist. The study assessed the presence of food residue in the stomach during esophagogastroduodenoscopy (EGD) and the adequacy of bowel preparation during colonoscopy.

Key Findings

In the EGD group, food was present in the stomach in four cases among those taking GLP-1 receptor agonists, while no food residue was observed in the control group. Among patients undergoing colonoscopy, inadequate bowel preparation was observed in 21.3% of those taking GLP-1 medications, compared to only 6.5% in the control group.

Clinical Implications

While no aspiration events or respiratory distress were reported, the researchers emphasized that the increased risk of food or stool residue could lead to significant issues. These include missed lesions, patient dissatisfaction, procedure cancellation, and wasted resources. The findings suggest a need for updated guidelines regarding the use of GLP-1 receptor agonists before endoscopic procedures.

Prior Research and Mechanisms

Previous studies have indicated that GLP-1 medications might increase the risk of aspiration during procedures requiring anesthesia. The current study extends these concerns by highlighting the potential for delayed gastric emptying and constipation caused by these drugs to interfere with the clarity of endoscopic procedures. The researchers suggest that further investigation is warranted to optimize patient preparation and minimize procedural complications.
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Reference News

[1]
GLP-1 Weight-Loss Meds Could Interfere With Endoscopy, Colonoscopy
drugs.com · Oct 1, 2024

Research in JAMA Network Open finds GLP-1 weight-loss meds like Ozempic, Wegovy, Mounjaro, and Zepbound increase risk of...

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