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Aspiration Risk During Endoscopic Procedures While on GLP-1 Agonist Therapy
Maryana Stryelkina1, Robert Molina1, Thomas Janice1
1Division of Internal Medicine, Department of Medicine, Baylor Scott & White Medical Center, Temple, TX, 76508, USA.
Digestive Diseases and Sciences
|August 9, 2025
Summary
Glucagon-like peptide-1 receptor agonist (GLP-1RA) use did not increase aspiration risk during endoscopic procedures like EGD or colonoscopy. Aspiration events were more common with EGD, but GLP-1RA therapy showed no association with increased risk.
Area of Science:
- Gastroenterology
- Endocrinology
- Patient Safety
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for Type 2 diabetes and weight management.
- Concerns exist regarding aspiration risk during endoscopy due to GLP-1RAs' effect on gastric emptying.
- Limited data exists on GLP-1RA users undergoing colonoscopy regarding aspiration risk.
Purpose of the Study:
- To evaluate and compare aspiration risk in patients undergoing esophagogastroduodenoscopy (EGD) versus colonoscopy.
- To determine if GLP-1RA therapy is associated with increased aspiration risk in these procedures.
Main Methods:
- Retrospective cohort study of 13,523 adult patients (18-70 years) from July 2017 to July 2024.
- Patients stratified by GLP-1RA use; primary outcome was aspiration-related diagnosis within 30 days (ICD-10 codes).
- Chi-square testing and logistic regression used to assess associations between procedure type, GLP-1RA use, and aspiration risk.
Main Results:
- Aspiration events were more frequent after EGD than colonoscopy (aOR=2.36, P=0.0200).
- No aspiration events were observed in patients using GLP-1RAs.
- Black race was associated with increased aspiration risk (aOR=2.77, P=0.0061); higher BMI was associated with lower risk.
Conclusions:
- Aspiration risk is higher with EGD compared to colonoscopy, independent of GLP-1RA use.
- GLP-1RA therapy was not associated with an increased aspiration risk in this cohort.
- Routine GLP-1RA use may not elevate aspiration risk in outpatient endoscopic settings; prospective studies are warranted.
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