GLP-1 and gastroparesis — when delayed emptying becomes pathological

Glad you're improving. For the community — this situation highlights why surgical patients should be particularly careful. The AGA and ASA have issued guidance that GLP-1 RAs should be held for at least 1 week (semaglutide) to 3 weeks before elective procedures requiring anesthesia, because residual gastroparesis increases aspiration risk during intubation.

If you're on a GLP-1 RA and have an upcoming surgery, tell your anesthesiologist even if your surgeon didn't ask. This is an active patient safety concern.

This is exactly why I get nervous about these drugs being treated so casually. They're powerful medications that fundamentally alter GI physiology. The vast majority do fine, but the people who don't can end up in serious situations. Informed consent and regular follow-up with a knowledgeable provider are non-negotiable.

FINAL UPDATE — 8 weeks post-discontinuation: Repeat gastric emptying study is normal. 8% retention at 4 hours (down from 62%). I'm eating normally again, no nausea, no vomiting. Full reversal.

My endocrinologist and GI doc are discussing whether I could trial a lower dose or a different GLP-1 RA in the future with close monitoring. For now, I'm just grateful my gut is working again. Thank you to everyone who shared their experience — it helped me stay calm during a really scary time.