DRINKING BEFORE ENDOSCOPY - MILK OR WATER

Background: The traditional fluid fast prior to endoscopy is unnecessa ry. We have previously shown that drinking water prior to endoscopy do es not affect either the quality of mucosal views or residual gastric fluid volumes when compared to patients undergoing endoscopy after a s tandard fast. The present study was designed to establish whether milk , which may delay gastric emptying, could also be drunk prior to endos copy without adverse effect. Methods: Forty-eight patients (mean age 4 8 years, range 20 to 79) undergoing routine upper gastrointestinal end oscopy after overnight fast were randomized to drink 200 ml of either still mineral water or full fat milk. Endoscopy was performed 90 minut es later, when all residual gastric fluid was aspirated via the endosc ope. Volume and pH of gastric aspirate were measured and the quality o f the mucosal view at endoscopy recorded as poor, adequate, or excelle nt. Results: No difference was shown between water (n = 27) and milk ( n = 21) drinkers in residual gastric volume (mean +/- SEM, water vs mi lk) (16.0 ml +/- 1.5 vs 18.9 ml +/- 2.9) or pH (2.23 +/- 0.14 vs 2.48 +/- 0.14). Of those patients with poor, adequate, or excellent views, 4 of 4, 11 of 12, and 6 of 32 patients, respectively, were milk drinke rs (chi-squared test for trend = 21.7, df = 1, p < 0.001), indicating significantly worse mucosal views in the group drinking milk. Conclusi on: Drinking water up to 90 minutes prior to endoscopy is safe, but mi lk should be discouraged because of suboptimal mucosal views.