What question did this study set out to answer?

The study aims to improve pre-procedural comfort for older patients undergoing painless gastroscopy by reducing fasting times.

March 13, 2026Open Access

Impact of reducing the duration of fasting and no drinking on the experiences of older patients receiving painless gastroscopy: a randomized controlled trial

Key Points

The study aims to improve pre-procedural comfort for older patients undergoing painless gastroscopy by reducing fasting times.
Randomized allocation of older patients (n = 904) to either study or control group.
Study group consumed 250 ml of opaque liquid 4 hours prior, and 250 ml of water 2 hours before the procedure.
Control group followed standard fasting guidelines for 6–8 hours and 4 hours respectively.
Outcomes included patient comfort, safety, and satisfaction, analyzed via intention-to-treat and per-protocol methods.
Study group reported significantly lower incidence of thirst, hunger, dizziness, and fatigue compared to control.
No significant differences in rates of gastric reflux, aspiration pneumonia, or endoscopic visibility between groups.
Satisfaction scores were notably higher in the study group than in the control group.

Abstract

Background Before undergoing painless gastroscopy, patients are required to fast and no drinking for at least 4 h which is unpleasant for older patients. Objective The aim of this study is to increase the preprocedural comfort of older patients by reducing the duration of fasting and no drinking before painless gastroscopy while ensuring safety. Methods Older patients aged more than 65 years who underwent painless gastroscopy were randomly allocated to the study group ( n = 452) and the control group ( n = 452). Those in the study group consumed 250 ml of opaque liquid 4 h prior to painless gastroscopy and 250 ml of water 2 h before the procedure. Those in the control group consumed the same food and water as those in the study group for 6–8 and 4 h, respectively. The primary outcome was patient comfort before the examination. The secondary outcomes included safety, gastroscopy effect and satisfaction in each group. All outcomes were analyzed using both intention-to-treat (ITT) and per-protocol (PP) approaches. Results In the study group, the incidence of thirst, hunger, dizziness, and fatigue before gastroscopy was significantly lower than that in the control group (33.4% vs . 42.7%, 20.1% vs . 28.1%, 3.1% vs . 7.5% and 4.9% vs . 11.7%, respectively; all P 0.05).Additionally, there was no difference in visual field clarity between the two groups (1.00 (1.00, 2.00) vs . 1.00 (1.00, 2.00), P > 0.05), but the satisfaction of the study group was significantly greater than that of the control group (97.00 (96.00, 99.00) vs . 93.00 (92.00, 95.00), P < 0.01). Conclusion In this random trial of older patients undergoing painless gastroscopy, ingestion of 250 ml opaque liquid 4 h before, followed by 250 ml water 2 h before, improved pre-procedure comfort and patient satisfaction compared with conventional fasting. We observed no statistically significant increase in clinically identified gastric reflux, aspiration, or impaired endoscopic field clarity; however, the incidence of such adverse events was low, and the trial was not powered to exclude small increases in rare but serious complications. Larger studies would be required to definitively establish safety equivalence.

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