Singh S, Suresh Kumar VC, Aswath G. Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: Guidelines, challenges, and future directions. World J Gastrointest Endosc 2024; 16(6): 292-296 [DOI: 10.4253/wjge.v16.i6.292]
Corresponding Author of This Article
Vishnu Charan Suresh Kumar, MBBS, Academic Research, Doctor, Division of Gastroenterology and Hepatology, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, United States. drvishnucharan@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jun 16, 2024; 16(6): 292-296 Published online Jun 16, 2024. doi: 10.4253/wjge.v16.i6.292
Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: Guidelines, challenges, and future directions
Sahib Singh, Vishnu Charan Suresh Kumar, Ganesh Aswath
Sahib Singh, Department of Internal Medicine, Sinai Hospital, Baltimore, MD 21215, United States
Vishnu Charan Suresh Kumar, Ganesh Aswath, Division of Gastroenterology and Hepatology, State University of New York Upstate Medical University, Syracuse, NY 13210, United States
Author contributions: Singh S and Suresh Kumar VC contributed equally to this paper; Suresh Kumar VC and Aswath G designed the overall concept and outline of the manuscript; Singh S contributed to the discussion and design of the manuscript; Singh S and Suresh Kumar VC contributed to the writing, and editing the manuscript, illustrations, and review of literature; Aswath G contributed to the writing and editing of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vishnu Charan Suresh Kumar, MBBS, Academic Research, Doctor, Division of Gastroenterology and Hepatology, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, United States. drvishnucharan@gmail.com
Received: March 1, 2024 Revised: April 28, 2024 Accepted: May 13, 2024 Published online: June 16, 2024 Processing time: 104 Days and 9.9 Hours
Abstract
Glucagon-like peptide receptor agonists (GLP-1RA) are used to treat type 2 diabetes mellitus and, more recently, have garnered attention for their effectiveness in promoting weight loss. They have been associated with several gastrointestinal adverse effects, including nausea and vomiting. These side effects are presumed to be due to increased residual gastric contents. Given the potential risk of aspiration and based on limited data, the American Society of Anesthesiologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in 2023. They included the duration of mandated cessation of GLP-1RA before sedation and usage of “full stomach” precautions if these medications were not appropriately held before the procedure. This has led to additional challenges, such as extended waiting time, higher costs, and increased risk for patients. In this editorial, we review the current societal guidelines, clinical practice, and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.
Core Tip: Glucagon-like peptide-1 receptor agonists can cause delay in gastric emptying. While the American Society of Anesthesiologists recommend holding these medications prior to all procedures, the American Gastroenterological Association recommends individualized approach prior to endoscopy due to inconclusive clinical data.
