Skip to main content

Advertisement

SpringerLink
Log in

Liraglutide Effects on Upper Gastrointestinal Investigations: Implications Prior to Bariatric Surgery

  • Brief Communication
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Liraglutide is a glucagon-like peptide type 1 (GLP-1) analogue that is approved for long-term obesity management in North America. While bariatric surgery remains the gold standard for weight loss, an increasing number of patients are on liraglutide in the setting of ongoing workup for bariatric surgery. The presence of gastrointestinal symptoms prior to bariatric surgery may prompt testing for dysmotility, which affects surgical decision making. Here we report six cases where treatment with liraglutide was associated with reversible reduction in gastric and esophageal motility in screening for bariatric surgery. While liraglutide is known to delay gastric emptying, there are minimal reports of how this medication affects gastrointestinal investigations used in this context. The implications of these abnormal screening investigations on candidacy for bariatric surgery are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Shaefer CF, Kushner P, Aguilar R. User's guide to mechanism of action and clinical use of GLP-1 receptor agonists. Postgrad Med. 2015;127(8):818–26.

    Article  Google Scholar 

  2. Novo Nordisk Canada Inc. Saxenda® Product Monograph. http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/OurProducts/PDF/Saxenda_PM_English.pdf. Published 2017 July 12. Accessed 10 December 2017.

  3. Naik RD, Choksi YA, Vaezi MF. Consequences of bariatric surgery on oesophageal function in health and disease. Nat Rev Gastroenterol Hepatol. 2016;13(2):111–9.

    Article  Google Scholar 

  4. Seok JW. How to interpret gastric emptying scintigraphy. J Neurogastroenterol Motil. 2011;17(2):189–91.

    Article  Google Scholar 

  5. Patel A, Gyawali CP. How to optimally apply impedance in the evaluation of esophageal dysmotility. Curr Gastroenterol Rep. 2016;18:60.

    Article  Google Scholar 

  6. Assef MS, Melo TT, Araki O, et al. Evaluation of upper gastrointestinal endoscopy in patients undergoing bariatric surgery. Arq Bras Cir Dig. 2015;28(Suppl 1):39–42.

    Article  Google Scholar 

  7. Piche T, Des varannes SB, Sacher-huvelin S, et al. Colonic fermentation influences lower esophageal sphincter function in gastroesophageal reflux disease. Gastroenterology. 2003;124(4):894–902.

    Article  Google Scholar 

  8. Van Can J, Sloth B, Jensen CB, et al. Effects of the once-daily GLP-1 analog liraglutide on gastric emptying, glycemic parameters, appetite and energy metabolism in obese, non-diabetic adults. Int J Obesity (2005). 2014;38(6):784–93.

    Article  Google Scholar 

  9. Horowitz M, Flint A, Jones KL, et al. Effect of the once-daily human GLP-1 analogue liraglutide on appetite, energy intake, energy expenditure and gastric emptying in type 2 diabetes. Diabetes Res Clin Pract. 2012;97(2):258–66.

    Article  CAS  Google Scholar 

  10. Nakatani Y, Maeda M, Matsumura M, et al. Effect of GLP-1 receptor agonist on gastrointestinal tract motility and residue rates as evaluated by capsule endoscopy. Diabetes Metab. 2017; [Epub ahead of print];43:430–7.

    Article  CAS  Google Scholar 

  11. Khemani D, Eckert D, O’Neil J, et al. Effect of liraglutide on gastric emptying at 5 and 16 weeks: a single-center, randomized, placebo-controlled trial in 32 patients. Gastroenterology. 2017;152(5):S83.

    Article  Google Scholar 

  12. Meier JJ, Rosenstock J, Hincelin-Mery A, et al. Contrasting effects of lixisenatide and liraglutide on postprandial glycemic control, gastric emptying, and safety parameters in patients with type 2 diabetes on optimized insulin glargine with or without metformin: a randomized, open-label trial. Diabetes Care. 2015;38(7):1263–73.

    Article  CAS  Google Scholar 

  13. Nagai Y, Hashimoto E, Oikawa R, et al. Differing effects of liraglutide on gastric emptying in Japanese patients with type 2 diabetes. Diabetes Obes Metab. 2014;16(6):573–6.

    Article  CAS  Google Scholar 

  14. Sun Z, Rodriguez J, Mcmichael J, et al. Surgical treatment of medically refractory gastroparesis in the morbidly obese. Surg Endosc. 2015;29(9):2683–9.

    Article  Google Scholar 

  15. Papasavas PK, Ng JS, Stone AM, et al. Gastric bypass surgery as treatment of recalcitrant gastroparesis. Surg Obes Relat Dis. 2014;10(5):795–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada

    Renuca Modi

  2. Edmonton Adult Bariatric Specialty Clinic, Royal Alexandra Hospital, Edmonton, CSC 472, 10240 Kingsway Avenue, Edmonton, AB, T5H 3V9, Canada

    Renuca Modi, Sarah Cawsey & Arya M. Sharma

  3. Richmond Road Diagnostic Treatment Centre, University of Calgary, Room 18126, 1820 Richmond Road SW, Calgary, AB, T2T 5C7, Canada

    Peter Rye

  4. Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, AB, Canada

    Sarah Cawsey & Arya M. Sharma

  5. Division of General Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada

    Daniel W. Birch

Authors
  1. Renuca Modi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Rye
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarah Cawsey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel W. Birch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arya M. Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Renuca Modi.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Dr. Modi has received speaker fees for educational events and honoraria for the development of educational materials from NovoNordisk Canada and Shire Pharma Canada. She has also received speaker fees from Valeant Canada and serves on the advisory board. Dr. Cawsey has received speaker fees and consulting fees from NovoNordisk Canada. Dr. Sharma has received speaker fees and consulting fees from NovoNordisk Canada and Merck.  He also serves on the advisory board for Valeant Canada.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Modi, R., Rye, P., Cawsey, S. et al. Liraglutide Effects on Upper Gastrointestinal Investigations: Implications Prior to Bariatric Surgery. OBES SURG 28, 2113–2116 (2018). https://doi.org/10.1007/s11695-018-3249-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3249-1

Keywords

Search

Navigation