A RECENT study highlights a concerning link between the use of GLP-1 receptor agonists (GLP-1RA) and inadequate bowel preparation for colonoscopies.
GLP-1RA drugs, widely used to manage diabetes and obesity, are known to slow gastrointestinal motility, potentially affecting the quality of bowel cleansing necessary for accurate colonoscopy screenings.
The retrospective cohort study, conducted at Mayo Clinic, USA, analysed 446 patients who underwent colonoscopy from December 2021–December 2022. Of these, 265 patients (59%) were current GLP-1RA users (cases), while 181 (41%) had previously used the drugs but stopped within 3 months before their procedure (controls). Both groups were similar in most baseline characteristics, except for a higher proportion of diabetes diagnoses among current users.
Using the Boston Bowel Preparation Scale (BBPS) to measure bowel preparation quality, researchers found that the average BBPS score was notably lower among current GLP-1RA users. The control group scored a mean of 7.5 out of 10, while the cases averaged 7.0, a statistically significant difference (P=0.046) even when adjusting for diabetes status. Additionally, 15.5% of GLP-1RA users had a total BBPS score below 5, indicating poor bowel preparation, compared to only 6.6% in the control group (P=0.01).
Poor bowel preparation also led to repeat colonoscopies for 18.9% of current GLP-1RA users, compared to 11.1% of controls (P=0.041). These findings suggest that GLP-1RA users may face a higher risk of inadequate screening results, which can diminish diagnostic accuracy and compromise patient safety.
The authors conclude that medical practitioners should consider the potential impact of GLP-1RA on bowel preparation quality. Enhanced guidance on pre-colonoscopy preparation for GLP-1RA users may be warranted to ensure effective screenings and reduce the need for repeat procedures.
Reference
Yao R et al. Effect of glucagon-like peptide-1 receptor agonists on bowel preparation for colonoscopy. Am J Gastroenterol. 2024;119(6):1154-7.
