MRCP Fasting Requirements
Fasting is generally not required for MRCP, as it is a non-invasive imaging technique that does not involve sedation, endoscopy, or aspiration risk. 1, 2
Why Fasting Is Not Necessary
- MRCP uses intrinsic T2 contrast between fluid in the biliary tree and surrounding organs to generate images without requiring contrast injection or procedural sedation 1
- No sedation or endoscopy is involved, eliminating the aspiration risk that necessitates NPO status for procedures like ERCP 2
- The non-invasive nature of MRCP distinguishes it from ERCP, which requires NPO status due to endoscopy and sedation with associated aspiration risks 2
Optional Preparation for Image Quality
While not mandatory, some imaging centers may use minimal preparation to optimize image quality:
- Antiperistaltic drugs may be administered to reduce bowel motion artifacts 2, 3
- Oral administration of tap water may be preferred at some centers to improve visualization 2, 3
- No patient preparation or sedation is required as a standard protocol 3
Clinical Context
The key distinction is between diagnostic imaging and therapeutic procedures:
- MRCP is purely diagnostic and does not require the same precautions as invasive procedures 1
- ERCP requires NPO status because it involves endoscopy, sedation, and carries risks of pancreatitis (3-5%), bleeding (2%), cholangitis (1%), and procedure-related mortality (0.4%) 2
- Recent evidence from contrast-enhanced CT studies demonstrates that fasting may be unnecessary even for procedures involving contrast administration, with no increased risk of aspiration pneumonitis or adverse gastrointestinal symptoms 4
Practical Approach
For routine MRCP scheduling:
- Patients can eat and drink normally prior to the examination 2, 3
- Check with your specific imaging center regarding their protocols, as some may have preferences for minimal preparation 2
- If gadolinium contrast is planned, no additional fasting is required unless the patient has specific contraindications 1