OCULUS Trial Finds GLP-1 Patients Need Medication Holds Before Endoscopy

# OCULUS Trial Finds GLP-1 Patients Need Medication Holds Before Endoscopy

Patients taking GLP-1 medications had significant residual gastric volume during upper endoscopy procedures unless they stopped the drugs beforehand or followed a clear liquid diet the day before, according to the OCULUS randomized trial reported by MedPage Endocrinology.

The clinical trial examined patients on GLP-1 or dual GLP-1/GIP agonists and found substantial retained stomach contents during endoscopy when medications weren't held prior to the procedure. This retained gastric material poses serious safety risks, including potential aspiration during sedation.

The findings address a growing clinical concern as millions of Americans now take medications like Ozempic, Wegovy, Mounjaro, and Zepbound. These drugs work partly by slowing gastric emptying, meaning food and liquids stay in the stomach longer than normal. While this contributes to weight loss by increasing satiety, it creates complications for medical procedures requiring an empty stomach.

Retained gastric contents during endoscopy can lead to aspiration pneumonia if stomach material enters the lungs during sedation. This potentially life-threatening complication has prompted many gastroenterologists to develop new protocols for GLP-1 patients.

The OCULUS trial results suggest two viable approaches for patients scheduled for upper endoscopy. The first involves temporarily stopping GLP-1 medications before the procedure, though the optimal timing varies by drug. The second approach allows patients to continue their medication while following a clear liquid diet the day before endoscopy.

Clinical Practice and Patient Guidance

Many endoscopy centers have already begun implementing new screening protocols, asking patients specifically about GLP-1 use during pre-procedure consultations. Some facilities now require longer fasting periods or automatically reschedule procedures if patients haven't properly prepared.

The research comes as demand for both GLP-1 medications and endoscopy procedures continues rising. Upper endoscopy rates have increased among weight loss patients, partly due to pre-surgical screening requirements and monitoring for gastroesophageal reflux disease.

Patients taking GLP-1 medications should inform their healthcare providers about these drugs when scheduling any procedure requiring sedation or an empty stomach. Rather than making independent decisions about stopping medications, patients should work with both their prescribing physician and procedural team to determine the safest approach based on the urgency of the procedure, the specific GLP-1 medication being used, and individual patient risk factors.