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A new set of studies from Hospital for Special Surgery (HSS) looked at how doctors check patients’ stomachs before surgery and found that job is getting harder. More people are using GLP-1 drugs (the class that includes popular weight-loss and diabetes medicines) and more people are using cannabis. Both of those things can change how the stomach behaves, which can make routine stomach checks less reliable and could affect anesthesia during operations. GLP-1 drugs are medicines that copy a natural gut chemical that tells your brain you’re full and slows how fast your stomach empties. You’ve probably heard brand names like Ozempic or Wegovy; those are forms of GLP-1 drugs. They’re used for diabetes and for weight loss. Cannabis is the active stuff from marijuana and can change digestion and the timing of stomach emptying too. Neither GLP-1 drugs nor cannabis are stomach-cleaning agents — they change stomach function in ways doctors didn’t expect when they set up pre-surgery rules. The HSS research looked at patients coming in for procedures and how well standard tests and questions predicted whether their stomachs were empty. The studies found that people taking GLP-1 drugs and those who use cannabis were more likely to have stomach contents when doctors expected them to be empty. The work included actual patient data from clinics (not just animal studies), but it’s not a single huge trial — it’s a collection of clinical observations and analyses. The effect was big enough that the researchers flagged it as a real concern for anesthesia safety, not just a minor curiosity. This matters because during anesthesia, if a patient’s stomach isn’t empty, there’s a risk that stomach contents can come up and go into the lungs (called aspiration), which can cause serious complications. Surgeons and anesthesiologists use a mix of fasting rules and bedside checks to reduce that risk. If those checks become less accurate because lots of patients are on GLP-1 drugs or are cannabis users, doctors may need to change how they assess risk or delay surgeries to keep patients safe. Patients who take these medications or use cannabis should expect more questions and possibly extra testing before surgery. There are important caveats. The studies point to an association — they don’t prove every person on a GLP-1 drug or who uses cannabis will have a dangerous stomach. The existing data come from clinical settings, and practices vary between hospitals. Side effects of GLP-1 drugs (like nausea or slower digestion) are known and relevant here; stopping medications suddenly isn’t always safe or recommended. Cannabis has variable effects depending on dose and frequency. Regulatory guidance on changing pre-op rules hasn’t universally changed yet, so this is more of a caution that protocols may need updating. Bottom line: Increasing use of GLP-1 drugs and cannabis can make it harder for doctors to be sure a patient’s stomach is empty before anesthesia, so patients should honestly report these substances and clinicians may need extra checks to keep surgeries safe.
Source: HSS | Hospital for Special Surgery