Delayed Gastric Emptying Under Treatment with GLP-1 Agonists

Figure

An 83-year-old male patient presented to the outpatient department for a follow-up gastroscopy due to previous upper gastrointestinal bleeding in the setting of a duodenal ulcer (Forrest Ib). Esophagogastroduodenoscopy showed the stomach to be almost completely filled with solid food residues despite the fact that the patient (according to his own report) had not eaten for 24 h (Figure). When questioned, the patient reported that he had been receiving privately prescribed semaglutide treatment for 6 months to lose weight. Treatment with mono or dual GLP-1/GIP agonists for weight reduction is on the rise in Germany and works by delaying gastric emptying, among other things. In a recent statement, the German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) recommends interrupting GLP-1 agonist treatment preoperatively due to the increased risk of aspiration. Should this approach also apply to endoscopic procedures in the upper gastrointestinal tract and should treatment with GLP-1 agonists already be documented during patient information? No studies are available as yet to provide a scientific answer to this question, but it should be addressed in the future due to its considerable clinical relevance.

PD Dr. med. Monika Rau, Prof. med. Alexander Meining, Medizinische Klinik II, Universitätsklinikum Würzburg, [e-mail]

Conflict of interest statement: MR is a sub-investigator in a phase-2 trial conducted by Novo Nordisk. AM declares that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Rau M, Meining A: Delayed gastric emptying under treatment with GLP-1 agonists. Dtsch Arztebl Int 2025; 122: 70. DOI: 10.3238/arztebl.m2024.0233