One-hour fast for water and six-hour fast for solids prior to endoscopy provides good endoscopic vision and results in minimum patient discomfort.

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One-hour fast for water and six-hour fast for solids prior to endoscopy provides good endoscopic vision and results in minimum patient discomfort.

J Gastroenterol Hepatol. 2009 Feb 11;

Authors: De Silva AP, Amarasiri L, Liyanage MN, Kottachchi D, Dassanayake AS, de Silva HJ

Abstract Background and Aim: Current guidelines for upper gastrointestinal endoscopy (UGIE) advise at least 6-8 h fasting for solids and 4-h fasting for liquids. We aimed to determine whether a 6-h fast for solids and one-hour fast for water prior to UGIE gives good endoscopic vision and less patient discomfort. Methods: 128 patients referred for UGIE were given a standard meal 6 h before endoscopy, and then randomized to either nil by mouth for 6 h (group A, n = 65) or allowed to drink water for up to one hour prior to endoscopy (group B, n = 63). Before endoscopy patients were requested to indicate discomfort due to fasting on a visual analog scale. Fluid in the gastric fundus was aspirated, when present, for volume and pH measurements, and endoscopic vision was graded. Results: 53 patients in group A and 43 patients in group B completed the study. Discomfort was significantly lower in group B than group A (P < 0.0001). Endoscopic vision was good in all 53 patients in group A and 40 in group B, and average in 3 patients in group B. Fluid in the gastric fundus was noted in 11 patients in group A and 16 in group B, but there were no significant differences in volume or pH between groups. There were no complications attributable to endoscopy in either group. Conclusions: A 6-h fast for solids and a 1-h fast for water prior to UGIE gives good endoscopic vision, and causes minimum patient discomfort.

PMID: 19220672 [PubMed - as supplied by publisher]

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