Patient Had Food in Stomach Despite Following Pre-Procedure Fasting Rules While on Semaglutide | Research

The takeaway

A patient on semaglutide had residual stomach contents despite standard fasting and withholding one dose, leading to procedure cancellation — but had no such issue on a prior occasion.

Unpredictable gastroparesis
Same patient, same preparation — different gastric emptying outcomes on two occasions

What the researchers found

Standard fasting guidelines plus withholding one semaglutide dose may not reliably ensure gastric emptying before endoscopy, with effects varying even in the same patient.

Why it matters

Millions of GLP-1 RA users will need sedated procedures. Inconsistent gastric emptying poses aspiration risk and creates anesthesia management challenges.

How the study worked

Case report comparing two endoscopy experiences in the same patient on semaglutide with identical preparation protocols.

What this study cannot tell us

Single case with inconsistent findings — the variable outcome makes it harder to draw conclusions than a consistent finding would.

How to read the evidence

Case report — illustrates a clinical challenge but cannot establish reliable risk estimates or optimal management strategies.

When this study was published

Published 2026 in A&A Practice.

The bigger picture

Current pre-procedure fasting guidelines may be inadequate for GLP-1 RA users. Standardized peri-procedural protocols for this growing patient population are urgently needed.

Questions still open

Should GLP-1 RA users have longer fasting periods or additional gastric emptying assessments before sedated procedures?
How many doses should be withheld to ensure adequate gastric emptying?

Common questions

Does semaglutide affect stomach emptying before procedures?

Yes — semaglutide slows stomach emptying, which can leave food in the stomach even after standard fasting. This is a concern for procedures requiring sedation due to aspiration risk.

How many doses of semaglutide should you skip before a procedure?

Current guidelines vary, and this case shows that skipping one weekly dose may not always be enough. Discuss a specific plan with your anesthesiologist and prescribing doctor.

Read the original research

Unexpected Residual Gastric Contents in a Patient After Holding Semaglutide After Standard Fasting Guidelines: A Case Report.

A&A practice, 20(2), e02161

View on PubMed ↗Publisher’s paper ↗

Citation

Ando, Kazuo; Takenoshita, Moe; Wei, Mike Tzuhen. (2026). Unexpected Residual Gastric Contents in a Patient After Holding Semaglutide After Standard Fasting Guidelines: A Case Report.. A&A practice, 20(2), e02161. https://doi.org/10.1213/XAA.0000000000002161