Aims
To identify clinical and procedural factors associated with adequate gastric cavity cleansing prior to upper gastrointestinal endoscopy.
Methods
A retrospective observational study was conducted on UGIE procedures performed at our center during the first quarter of 2025. Adult patients were categorized according to the quality of gastric preparation (adequate vs. suboptimal).
Variables analyzed included medical history, chronic medication use, BMI, abdominal circumference, alcohol consumption, physical activity on the day of the procedure, bowel habits, use of laxatives and/or prokinetics, ASA classification, and fasting hours for both liquids and solids.
Exclusion criteria: patients under 18 years of age and those with previous gastrointestinal resections.
Results
A total of 205 patients were included (117 women, 88 men; mean age 51 years). Adequate preparation was observed in 192 patients, while 13 had suboptimal preparation (6.34% of the total sample).
Statistically significant differences between groups were found in BMI, abdominal circumference, and fasting duration for both liquids and solids.
Comparison of variables between groups with adequate and inadequate gastric–duodenal preparation
|
Variable |
Total sample (n=205) |
Good preparation (n=192) |
Poor preparation (n=13) |
p value (<0.05) |
|---|---|---|---|---|
|
Sex (n) |
Women: 117 Male: 88 |
Women: 109 Male: 83 |
Women: 8 Male: 5 |
0.072 |
|
Median age (years) |
51 (W: 53 / M: 49) |
51 |
48 |
0.083 |
|
Median BMI |
25.6 (W: 25.6 / M: 27.75) |
25.55 |
26.8 |
0.045 |
|
Median abdominal circumference (cm) |
92 |
92 |
97 |
0.012 |
|
Diabetes Mellitus (DM) |
18 |
16 |
2 |
0.650 |
|
Hypothyroidism |
14 |
12 |
2 |
0.219 |
|
|
||||
|
Bowel movement frequency |
2–5/week: 30 Daily: 145 >1/day: 30 |
2–5/week: 28 Daily: 136 >1/day: 28 |
2–5/week: 2 Daily: 9 >1/day: 2 |
0.998 |
|
ASA classification |
ASA I–II: 192 ASA III–IV: 13 |
ASA I–II: 179 ASA III–IV: 13 |
ASA I–II: 13 ASA III–IV: 0 |
— |
|
Physical activity on the day |
None: 143 Walking: 53 Aerobic: 9 |
None: 134 Walking: 50 Aerobic: 8 |
None: 9 Walking: 3 Aerobic: 1 |
0.906 |
|
Median fasting time for liquids (h) |
8 |
8 |
5.5 |
0.003 |
|
Median fasting time for solids (h) |
9 |
10 |
6.5 |
0.023 |
Conclusions
Adequate fasting time for both liquids and solids is crucial to ensure optimal gastric cleansing. Patients with higher BMI and larger abdominal circumference are at greater risk of residual gastric contents despite standard fasting recommendations. Extending fasting duration in this subgroup may improve the quality of endoscopic evaluations.