From the Guidelines
You should follow a clear liquid diet the day before an endoscopy, even if you took semaglutide a month earlier, to minimize the risk of complications and ensure the best possible outcomes for morbidity, mortality, and quality of life. This diet typically includes water, clear broths, coffee or tea without milk, clear juices without pulp, sports drinks, gelatin, and popsicles without fruit pieces. It is essential to avoid red, purple, or blue colored liquids as they can interfere with visualization during the procedure 1. The most recent and highest quality study by Silveira et al. found that patients who used semaglutide had a higher incidence of retained gastric contents, despite extended fasting times, highlighting the importance of careful dietary management before the procedure 1.
The clear liquid diet is crucial because it helps ensure your stomach and upper digestive tract are empty, allowing the doctor to clearly see the lining of your digestive tract during the examination. Although semaglutide has a half-life of about one week, and taking it a month prior should not significantly impact your preparation or the procedure itself, the medication's effects on gastric emptying and the risk of pulmonary aspiration under anesthesia cannot be entirely ruled out 1. Therefore, it is vital to follow the specific pre-procedure instructions provided by your healthcare provider, as they may have additional recommendations based on your individual health situation.
Some key points to consider when following a clear liquid diet before an endoscopy include:
- Avoiding solid foods and opting for clear liquids only
- Staying hydrated with water, clear broths, and electrolyte-rich beverages like sports drinks
- Avoiding red, purple, or blue colored liquids that could interfere with the procedure
- Informing your healthcare provider about any medications you are taking, including semaglutide, and following their specific guidance on medication management before the procedure. Always prioritize the instructions given by your healthcare provider, as they are tailored to your specific needs and medical history 1.
From the Research
Safe Foods to Eat Before Endoscopy
When taking semaglutide a month earlier, it's essential to consider the potential effects of the medication on gastric emptying and residual gastric content. The following points summarize the key findings:
- Semaglutide use has been associated with delayed gastric emptying and increased residual gastric content (RGC) in patients undergoing elective upper endoscopy 2, 3, 4.
- The risk of increased RGC is higher in patients who have taken semaglutide within 30 days prior to the endoscopy, especially if they have ongoing digestive symptoms such as nausea, vomiting, dyspepsia, and abdominal distension 2, 4.
- To minimize the risk of increased RGC, it's recommended to discontinue semaglutide for at least 14-21 days before the endoscopy, depending on the presence of digestive symptoms 4.
Dietary Recommendations
Given the potential effects of semaglutide on gastric emptying, it's crucial to follow a light diet the day before the endoscopy to reduce the risk of residual gastric content. Some safe food options may include:
- Clear liquids, such as water, broth, or electrolyte-rich beverages
- Plain toast or crackers
- Low-fat, low-fiber foods, such as plain rice, bananas, or applesauce
- Avoiding heavy, fatty, or high-fiber foods that can slow down gastric emptying
Key Considerations
When planning your diet the day before the endoscopy, keep in mind:
- Semaglutide can increase the risk of gastrointestinal adverse events, such as nausea, diarrhea, and vomiting 5, 6.
- The medication should be taken on an empty stomach, at least 30 minutes before eating or drinking anything else 5, 6.
- It's essential to follow the recommended dietary instructions and guidelines provided by your healthcare provider to ensure a safe and successful endoscopy procedure.