Association of semaglutide with retained gastric contents on endoscopy: Retrospective analysis

Abstract

Background and study aims

We investigated the effect of semaglutide, a glucagon-like peptide-1 (GLP-1) agonist therapy, on retained gastric contents during endoscopy through a retrospective case-control study.

Patients and methods

We performed a retrospective case-control study to evaluate the effect of semaglutide on rates of retained gastric contents (RGC) visualized during esophagogastroduodenoscopy (EGD). Cases and controls were matched using multidimensional propensity score matching: age, gender, body mass index, and EGD indication. Pairs were analyzed using McNemar testing and Mann-Whitney non-parametric tests.

Results

Of the patients on GLP-1 therapy at time of EGD, 12.5% had RGC, compared with 1.3% in the control group (confidence interval [CI] 7.2% to 17.7%, P < 0.0001). Approximately 23% of patients prescribed GLP-1 therapy for weight loss had RGC at time of EGD compared with the control group (CI 13.4% to 32.6%, P < 0.0001). Only 2.6% of patients prescribed GLP-1 therapy for diabetes had RGC at time of EGD compared with the control group (CI -0.9% to 6.1%, P = 0.5). Patients receiving GLP-1 therapy with RGC at time of EGD did not differ from non-RGC patients in dosing of GLP-1 agonist (P = 0.23) or duration of GLP-1 agonist use prior to EGD (P = 0.98).

Conclusions

Semaglutide use appears to increase risk of having retained gastric contents visualized during endoscopy. Patients on semaglutide for weight loss appear to have a greater risk of RGC compared with patients on semaglutide for glycemic control. This observation may have clinical implications for management of GLP-1 agonist use prior to endoscopy.

Keywords

Endoscopy Upper GI Tract - Quality and logistical aspects - Sedation and monitoring - Performance and complications

Publication History

Received: 02 August 2024

Accepted after revision: 14 February 2025

Accepted Manuscript online:
03 March 2025

Article published online:
04 April 2025

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