P0397 - Single Center Assessment of the Boston Bowel Preparation Scale Score Among Patients With Obesity Who Are Receiving Semaglutide During the Time of Colonoscopy

Luis M.. Nieto, MD¹, Sharon Narvaez, MD², Olanrewaju Adeniran, MBBS³, Do Han Kim, MD⁴, Donghyun Ko, MD⁵, Shailendra Singh, MD³, Jesse Thompson, PhD^3
1Emory University School of Medicine, Atlanta, GA; ²Universidad de Guayaquil, School of Medicine, Atlanta, GA; ³West Virginia University, Morgantown, WV; ⁴Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; ⁵Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT

Introduction: Semaglutide is commonly prescribed for weight loss and type 2 diabetes mellitus (DM2). However, this medication can induce a delay in gut motility, which may affect bowel preparation for colonoscopies. This study aimed to assess this primary outcome.

Methods: Adult patients undergoing colonoscopy from 1/1/2021 through 10/31/2023 across a single center were identified. Data were collected from the medical record on patient comorbidities, type of bowel preparation, concurrent medications, and Boston Bowel Preparation Scale (BBPS). A Fisher’s exact test for the analysis of contingency tables and χ² test for categorical variables were performed to compare failure or success BPPS scores (defined by < 6 or =/ > 6, respectively). Multivariate logistic regression was used to identify predictors of inadequate bowel prep.

Results: A total of 156 patients were included. The majority were female 110 (70.5%) and Caucasian 151 (96.8%). Mean BMI was 38.4 (SD ± 7.0) and the obesity classes distribution were: class I 51 [32.9%], class II 49 [31.6%] and class III 55 [35.5%]). The majority of patients were taking Semaglutide for more than 6 months 104 (67.9%) and did not stop the medication for colonoscopy 110 (73.8%). A significantly higher proportion of patients on Semaglutide had DM2 127 (81.4%) and used other medications like antihypertensives 121 (77.5%), antiseizures 40 (25.6%), opioids 31 (19.9 %) and tricyclic antidepressants 12 (7.6%) at the time of colonoscopy. GoLYTELY was the most used bowel preparation 116 (74.4%). Patients who stopped Semaglutide 1 week or more prior colonoscopy were not associated with lower bowel prep failure, in fact a greater percentage of patients had stopped semaglutide usage in the bowel prep failure cohort, 28.6% vs 24.6% (p = 0.85). In the multivariate logistic regression model, use of Semaglutide, presence of DM2, other comorbidities and medications associated with bowel prep failure were examined and the only significant variables associated with failure (AIC method of variable reduction) were antihypertensives, tricyclic anti depressives and antiseizures.

Discussion: In this retrospective study, Semaglutide discontinuation before colonoscopy was not associated with improvement of the quality of bowel prep based on BBPS scores in patients with obesity. A prospective study using large sample sizes, controlling with previous failure of bowel prep and use of medication associated with constipation is needed to determine the mechanisms behind these findings.


Disclosures:


Luis M.. Nieto, MD¹, Sharon Narvaez, MD², Olanrewaju Adeniran, MBBS³, Do Han Kim, MD⁴, Donghyun Ko, MD⁵, Shailendra Singh, MD³, Jesse Thompson, PhD³. P0397 - Single Center Assessment of the Boston Bowel Preparation Scale Score Among Patients With Obesity Who Are Receiving Semaglutide During the Time of Colonoscopy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.