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Study breakdown

GLP-1 drugs increase retained gastric contents before endoscopy, but same-day colonoscopy prep reduces this risk

RPEP-138542025Ukwade, Dirin; Hernandez, Luis J; Modi, Zeel; Raza, Hasan S; Siegel, Michael; Nwachukwu, Dexter; Sarraf, Paya; Memon, Abdullah; Booth, Marya; Cooper, Karen; Boulay, Brian R; Mutlu, Ece A
evidence
The takeaway

GLP-1 drug users have significantly more retained gastric contents on EGD, but patients who undergo same-day colonoscopy (with bowel prep) have reduced retained gastric content risk—suggesting colonoscopy prep serves as effective gastric preparation.

Same-day colonoscopy = solution

Colonoscopy bowel preparation also empties the stomach—reducing GLP-1 drug-associated retained gastric content and providing a practical management strategy for endoscopy safety

What the researchers found

GLP-1 drug users: significantly ↑retained gastric contents on EGD. Same-day colonoscopy: ↓retained gastric content risk. Colonoscopy bowel prep: effectively empties stomach. Practical solution identified.

Why it matters

This provides a practical solution: when GLP-1 drug users need upper endoscopy, scheduling a same-day colonoscopy (with its bowel preparation) effectively prepares the stomach too.

How the study worked

Retrospective analysis of retained gastric contents during EGD in GLP-1RA users. Comparison: EGD alone vs same-day EGD + colonoscopy.

What this study cannot tell us

Retrospective. Cannot determine optimal preparation protocol. Sample sizes in full study. Not all patients need colonoscopy.

How to read the evidence

Retrospective analysis with practical clinical finding.

When this study was published

Published in 2025.

The bigger picture

Rather than canceling or delaying procedures for GLP-1 drug users, scheduling same-day colonoscopy provides both procedures while addressing the gastric content concern through bowel preparation.

Questions still open

  • Should all GLP-1 users have colonoscopy-grade prep before EGD?
  • Would a clear liquid diet alone be sufficient?
  • Is the aspiration risk truly reduced with bowel prep?

Common questions

Is it safe to have an endoscopy while on GLP-1 drugs?
GLP-1 drugs increase the chance of having food left in the stomach during upper endoscopy. However, this study found a practical solution: having a colonoscopy bowel preparation (clear liquids + laxatives) before the procedure effectively empties the stomach too, reducing the risk.
Do I need to stop my GLP-1 drug before endoscopy?
Rather than stopping the drug, this study suggests an alternative: if you need upper endoscopy, having colonoscopy-type bowel preparation beforehand—or scheduling both procedures on the same day—effectively addresses the retained gastric content concern.

Read the original research

GLP-1 receptor agonist increase retained gastric contents on EGD and same-day colonoscopy reduces this risk.

Frontiers in medicine, 12, 1638981

View on PubMed ↗Publisher’s paper ↗

Citation

Ukwade, Dirin; Hernandez, Luis J; Modi, Zeel; Raza, Hasan S; Siegel, Michael; Nwachukwu, Dexter; Sarraf, Paya; Memon, Abdullah; Booth, Marya; Cooper, Karen; Boulay, Brian R; Mutlu, Ece A. (2025). GLP-1 receptor agonist increase retained gastric contents on EGD and same-day colonoscopy reduces this risk.. Frontiers in medicine, 12, 1638981. https://doi.org/10.3389/fmed.2025.1638981