One-hour fast for water and six-hour fast for solids prior to endoscopy provides good endoscopic vision and results in minimum patient discomfort.
OBJECTIVE
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.
De Silva
Arjuna P
AP
Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. apdsilva@yahoo.com
Amarasiri
Lakmali
L
Liyanage
Manohari N
MN
Kottachchi
Dulani
D
Dassanayake
Anuradha S
AS
de Silva
H Janaka
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D016145:Endoscopy, Digestive System / Q000009:adverse effects; D005215:Fasting / Q000009:adverse effects; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018709:Statistics, Nonparametric; D014867:Water / Q000008:administration & dosage
D014867:Water