The growing use of GLP-1 receptor agonists creates perioperative safety concerns for gastroenterology procedures due to their effect of slowing stomach emptying.
Delayed gastric emptyingGLP-1 drugs' appetite-suppressing mechanism becomes a safety concern during endoscopy, where retained stomach contents increase aspiration risk
What the researchers found
GLP-1 receptor agonists significantly delay gastric emptying, which raises the risk of retained gastric contents in patients presenting for endoscopic procedures. This is a key safety concern because residual food in the stomach during sedation increases aspiration risk. The review highlights that healthcare practitioners need evidence-based protocols for managing GLP-1 users before, during, and after gastrointestinal procedures, including considerations about medication timing and fasting instructions.
Why it matters
With GLP-1 drugs now among the most prescribed medications globally, gastroenterology practices are encountering more and more patients on these drugs who need procedures like colonoscopy or upper endoscopy. The delayed gastric emptying effect — while therapeutic for appetite control — becomes a safety hazard when patients need sedation. Clear guidelines are essential to prevent aspiration events, which can be life-threatening.
How the study worked
This is a narrative review article synthesizing existing evidence and clinical concerns about GLP-1 receptor agonist use in patients undergoing gastroenterology procedures, with particular focus on delayed gastric emptying and perioperative safety.
What this study cannot tell us
This is a narrative review without systematic methodology, so the coverage of evidence may not be comprehensive. The abstract does not present specific data on aspiration rates or outcomes in GLP-1 users undergoing procedures. The rapidly evolving clinical landscape around GLP-1 drugs means recommendations may change as new evidence emerges.
How to read the evidence
This is a narrative review article summarizing existing concerns and evidence. It provides clinical context and guidance but does not present new primary data or use systematic review methodology.
When this study was published
Published in 2025, this review addresses a highly current safety concern as GLP-1 receptor agonist prescribing continues to surge globally.
The bigger picture
This review reflects a broader pattern in medicine where the rapid adoption of a drug class creates unforeseen challenges in other clinical settings. As GLP-1 receptor agonists expand from diabetes management into weight loss and potentially cardiovascular and liver disease, their effects on gastric motility will intersect with an increasing number of medical procedures and specialties beyond gastroenterology.
Questions still open
- What is the optimal fasting period before endoscopy for patients on different GLP-1 receptor agonists?
- How long after stopping GLP-1 drugs does gastric emptying return to normal rates?
- Are aspiration events during endoscopy actually more frequent in GLP-1 users compared to the general population?
Common questions
Should I stop my GLP-1 medication before a colonoscopy or endoscopy?
Why does slower stomach emptying matter for medical procedures?
Read the original research
Glucagon-Like Peptide-1 (GLP-1a) Receptor Agonist Use in Patients Presenting for Gastroenterology Procedures: A Review of Concerns.
Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates, 48(5), 389-395
Citation
Wunder, Linda; Lee, Rebecca; Dalpé Welliver, Dawn. (2025). Glucagon-Like Peptide-1 (GLP-1a) Receptor Agonist Use in Patients Presenting for Gastroenterology Procedures: A Review of Concerns.. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates, 48(5), 389-395. https://doi.org/10.1097/SGA.0000000000000891