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Introduction <p>Our study has two objectives: (1) to evaluate the incidence and severity of food retention observed during esophagogastroduodenoscopies (EGDs) in patients with and without history of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and (2) to create a grading scale to standardize the language regarding food retention. GLP-1 RAs have gained attention for treating obesity and type 2 diabetes (T2DM), largely due to their ability to reduce gastric motility. We aim to evaluate if this reduction leads to increased gastric food retention, raising the risk of aspiration.</p> Methods &amp; Procedures <p>A retrospective cross-sectional study was performed on patients who underwent an EGD from 2022 to 2024. The chi-square test was used to evaluate associations between categorical variables, including sex, gastroparesis diagnosis, T2DM diagnosis, and the presence of retained gastric contents (categorized by grade). Fisher’s exact test was employed in cases where expected cell counts were less than five.</p> Results <p>The study consisted of 150 patients, with 73 GLP-1 RA users in the experimental group and 77 non-users in the control group. Most patients in both groups had no significant gastric retention at the time of EGD. When retention grades were grouped into a binary classification (None/A vs. B/C/D), there was no significant association between GLP-1 RA use and gastric retention (p = 0.67). Patients in the experimental group were significantly more likely to have a documented diagnosis of gastroparesis (p &lt; 0.001) and T2DM (p &lt; 0.001) as compared to the control group.</p> Conclusions <p>Our initial data suggest that GLP-1 RA use does not lead to substantial gastric food retention as observed in EGDs. We propose using this study’s grading scale as the standard for quantifying gastric food retention. By defining stages from no residue to severe obstruction, it enhances study comparisons and procedure planning while promoting a shared understanding among providers.</p> Graphic Abstract <p></p>

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A single-center retrospective review of food retention during upper endoscopy following GLP-1 receptor agonist usage and introduction of the Tampa Intraluminal Gastric Residue (TiGR) grading scale

  • 期刊论文

  • 发表日期：

    2026年3月2日

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  • Yash Patel,
  • Alice McDonald,
  • George Malcolm Taylor,
  • Theo Sher,
  • Christopher DuCoin,
  • Joseph Sujka,
  • Salvatore Docimo

摘要

Introduction

Our study has two objectives: (1) to evaluate the incidence and severity of food retention observed during esophagogastroduodenoscopies (EGDs) in patients with and without history of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and (2) to create a grading scale to standardize the language regarding food retention. GLP-1 RAs have gained attention for treating obesity and type 2 diabetes (T2DM), largely due to their ability to reduce gastric motility. We aim to evaluate if this reduction leads to increased gastric food retention, raising the risk of aspiration.

Methods & Procedures

A retrospective cross-sectional study was performed on patients who underwent an EGD from 2022 to 2024. The chi-square test was used to evaluate associations between categorical variables, including sex, gastroparesis diagnosis, T2DM diagnosis, and the presence of retained gastric contents (categorized by grade). Fisher’s exact test was employed in cases where expected cell counts were less than five.

Results

The study consisted of 150 patients, with 73 GLP-1 RA users in the experimental group and 77 non-users in the control group. Most patients in both groups had no significant gastric retention at the time of EGD. When retention grades were grouped into a binary classification (None/A vs. B/C/D), there was no significant association between GLP-1 RA use and gastric retention (p = 0.67). Patients in the experimental group were significantly more likely to have a documented diagnosis of gastroparesis (p < 0.001) and T2DM (p < 0.001) as compared to the control group.

Conclusions

Our initial data suggest that GLP-1 RA use does not lead to substantial gastric food retention as observed in EGDs. We propose using this study’s grading scale as the standard for quantifying gastric food retention. By defining stages from no residue to severe obstruction, it enhances study comparisons and procedure planning while promoting a shared understanding among providers.

Graphic Abstract