Optimal approach to prohibit drinking water prior to EGE in middle-aged and elderly individuals

BACKGROUND: Electronic gastroscopic examination (EGE) is the most effective and reliable method for the screening and diagnosis of upper gastrointestinal diseases. Prolonged prohibition of drinking water before EGE may lead to discomfort in patients. AIM: To identify whether water-deprivation duration can be safely minimized in unsedated EGE for middle-aged/elderly patients without gastric emptying disorders. METHODS: A total of 252 middle-aged and elderly patients who underwent unsedated EGE at the Shaanxi Cancer Hospital endoscopy center were randomly assigned to three groups: the control group (drinking 200 ml of warm water 6 h before EGE), Experimental group A ( 200 ml of warm water 2 h before EGE), and Experimental group B ( 200 ml of warm water 1 h before EGE). Prior to EGE, patient discomfort and anxiety levels were assessed 15 min beforehand. Residual gastric volume (RGV) and clarity of the visual field (EVFC) during EGE were also evaluated. RESULTS: The Experimental groups showed lower scores for thirst, dryness of the mouth, nausea, vomiting, and weakness than the control group. No significant intergroup differences were observed in EVFC and RGV qualified rates among the two experimental groups and the control group. However, Experimental group B showed an unfavorable downward trend in RGV qualified rate. No adverse events such as aspiration occurred in either group. CONCLUSION: For middle-aged and elderly patients without gastric emptying disorders, drinking 200 ml of warm water 2 h prior to EGE is recommended. This strategy improves patients' comfort and mood, and maintains normal EVFC and RGV. Even though 1-hour water intake results in no statistically significant differences in RGV and EVFC, it presents an unfavorable trend of reduced RGV qualified rate.