A recent study has found that glucagon-like peptide 1 receptor agonists (GLP-1 RAs), commonly used for treating diabetes or obesity, are linked to lower quality bowel preparation for colonoscopies and an increased need for repeat procedures. This research was conducted by a team led by Dr. Eric J. Vargas from the Mayo Clinic in Rochester, Minnesota, and published in the American Journal of Gastroenterology.
Key Findings:
- Inadequate Bowel Preparation: The study observed a notably higher rate of inadequate bowel preparation among patients on GLP-1 RAs. This necessitates a repeat colonoscopy within 12 months for effective colorectal cancer screening and surveillance. For every 14 patients treated with GLP-1 RAs, one required a repeat colonoscopy due to suboptimal preparation.
- Study Methodology: The research analyzed patients who underwent screening or surveillance colonoscopy at the Mayo Clinic between 2021 and 2022. The Boston Bowel Preparation Scale (BBPS) was used to assess the quality of bowel preparation. The study included 446 patients, with 265 (59%) taking a GLP-1 RA and 181 controls (41%).
- Results and Implications: After adjusting for diabetes, the mean BBPS score was significantly higher in controls than in GLP-1 RA recipients. The percentage of patients with a total BBPS score less than 5 was significantly higher in the GLP-1 RA group. The study highlights the need for clinicians to consider patients on GLP-1 RAs as at risk for poor quality bowel preparation.
The findings are significant as GLP-1 RAs are increasingly used for diabetes and obesity treatment. They are known to reduce gastrointestinal motility, which may contribute to suboptimal bowel preparation. This study underscores the importance of considering medication effects when preparing patients for colonoscopies.