P0201 - Assessing Appropriate Bowel Cleansing For Veteran Patients Undergoing Colonoscopy Who Use GLP-1 Agonist Medications

Kyle Pierce, DO¹, Elvis J. Arteaga, MD², Natasha Narang, DO¹, Rakesh Nanda, MD, FACG^3
1University of Arizona College of Medicine, Phoenix VA Medical Center, Phoenix, AZ; ²University of Arizona College of Medicine, Phoenix, AZ; ³Carl T. Hayden Veterans' Administration Medical Center, Phoenix, AZ

Introduction: Effective bowel preparation is essential prior to a colonoscopy to optimize the detection of CRC and precancerous colon polyps, and is an important quality metric for colonoscopy. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are currently approved for the management of weight loss and diabetes, and used frequently amongst the Veteran population. Though effective, GLP-1 RA medications have numerous gastrointestinal side effects, including delayed gastrointestinal motility. We aimed to assess the incidence of inadequate bowel preparation for colonoscopy in patients who are prescribed GLP-1 RA, and to determine if use of GLP-1 RA increases the need for repeat colonoscopy in Veteran patients at the Phoenix VA Medical Center.

Methods: This quality improvement project was a retrospective review of colonoscopies performed between January to February 2023 . For each colonoscopy, the chart was reviewed to identify age, gender, use of GLP-1 RA, colonoscopy indication, procedure time, Boston Bowel Preparation Score (BBPS), documented adequacy of bowel preparation and need for repeat colonoscopy due to quality of bowel preparation. For those who used GLP-1 RA medications, the specific GLP-1 RA type and indication of use were also assessed.

Results: A total of 200 patients underwent colonoscopy during the observed period. Of this, 101 were using GLP-1 RA medications, and 99 were not using GLP-1 RA medications. The average age amongst patients was 65.3 in the GLP-1 RA group, and 63.5 in the group without. The average BBPS was significantly lower in the GLP-1 cohort at 7.09 compared to 8.33 (p < .01). Notably, a significant amount of patients in the GLP-1 RA cohort required repeat colonoscopy due to poor bowel 17 prep compared to the non-GLP-1 RA group.

Discussion: GLP-1 RA are well known for delayed gastric motility. In our quality improvement project, a significant difference in bowel cleanliness for colonoscopy amongst patients on GLP-1 RA medications compared to patients without. In our analysis, the BBBPS between cohorts was notably different. On a clinical level, this difference resulted in a significant increase in number of rescheduled colonoscopy due to poor bowel prep and delay identification of high-risk polyps. This project overall suggests that the use of GLP-1 RA negatively impacts colonic emptying, particularly in patients undergoing bowel preparation for colonoscopy, which may lead to decreased efficacy of colorectal cancer screening by colonoscopy.


Disclosures:


Kyle Pierce, DO¹, Elvis J. Arteaga, MD², Natasha Narang, DO¹, Rakesh Nanda, MD, FACG³. P0201 - Assessing Appropriate Bowel Cleansing For Veteran Patients Undergoing Colonoscopy Who Use GLP-1 Agonist Medications, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.