Intragastric balloon at Sachsenhausen Clinic, Germany, Frankfurt

Intragastric Balloon

Intragastric balloon at Sachsenhausen Clinic, Germany, Frankfurt

An intragastric balloon installation, in contrast to gastric banding and stomach reduction surgeries, is a non-surgical procedure to treat obesity. It is designed to help overweight people to lose weight.

The mechanism of action of the intragastric balloon is based on the simple assumption that a balloon filled with liquid or air occupies so much space in the stomach that its possessor becomes saturated faster and thus eats less. The feeling of fullness arises mainly due to the stretching of the walls of the stomach. But the intragastric balloon can only constitute part of the treatment of obesity, as lifestyle and nutrition play an important role.

The intragastric balloon is made of soft silicone. It is filled with liquid or air. The intragastric balloon is installed and removed during gastroscopic study.

Who Can Use the Intragastric Balloon?

Unlike other bariatric interventions (gastric banding, sleeve gastroplasty, gastric bypass, etc.) that are used in cases of very severe obesity, the intragastric balloon is installed even in people who are slightly overweight (with a body mass index of between 28 and 40 kg/m²). In most cases, the intragastric balloon is installed in people weighing between 85 and 130 kilograms. In the case of very overweight people, this method is sometimes used to prepare for stomach reduction surgery in order to reduce weight a little prior to the operation and thus reduce surgical risks.

Who is the Intragastric Balloon Not Suitable for?

In certain physical and mental diseases, the intragastric balloon should not be installed (it is contraindicated). The contraindications include previous surgeries, gastric or esophageal diseases or defects, stomach ulcers, as well as addictive disorders such as alcoholism or drug addiction. The intragastric balloon should also be rejected in the case of severe eating disorders, such as bulimia or other severe mental illnesses. In addition, this method is not suitable for pregnant women. People who have to continuously take medications that reduce blood clotting should not be given an intragastric balloon either.

How is the Intragastric Balloon Installed?

Before installing the intragastric balloon, it is necessary to examine the esophagus and stomach (conduct an esophagogastroscopy). This check-up is used to detect pathological changes that make it impossible to install the intragastric balloon. When gastroscopy is performed, the doctor inserts the so-called endoscope into the stomach through the mouth and esophagus. The endoscope is equipped with a lighting source and a camera. In this way, the doctor can examine the esophagus and stomach for pathological changes.

To install the balloon, the doctor pulls out the endoscope and inserts the folded intragastric balloon by means of a probe. When the balloon enters the stomach, the doctor uses the endoscope to check the position of the balloon. Finally, the balloon is filled through the probe with approximately 400-700 milliliters of blue colored salt solution. Then the doctor removes the probe and again using the endoscope checks whether the balloon is positioned properly.

The intervention lasts approximately 20-30 minutes and is carried out under conscious sedation. It can be performed on an outpatient basis. However, because of anesthesia, the patient cannot drive a car.

Some patients suffer from stomach aches, nausea and vomiting after the balloon has been installed. A hospital stay of about 1-2 days is required to restore the patient's fluid level intravenously.

How is the Intragastric Balloon Removed?

The intragastric balloon is removed six months after its installation at the latest, thus reducing the risk of the balloon wall rupture as a result of the constant impact of the gastric juice and stomach movements. A repeated gastroscopy is necessary to remove the intragastric balloon. During the intervention, the balloon is punctured to remove the liquid from it. As a result, the intragastric balloon loses its elasticity and can be easily taken out through the esophagus. The whole procedure usually lasts only a few minutes.

Effectiveness of the Intragastric Balloon

The effectiveness of the intragastric balloon can vary greatly from patient to patient. The actual weight loss is approximately between 10 and 25 kilograms. Weight loss is especially pronounced in the first three months.

The effect of weight loss depends largely on how well the patient manages to maintain the altered diet at the same time. Those people who consume a lot of sweet drinks or sweets, despite the intragastric balloon, may continue to get fatter. In general, the effectiveness of the intragastric balloon is considerably lower than that of surgical techniques.

Side Effects

Mainly during the first days after the installation of the intragastric balloon there can be significant side effects. Nausea, stomach cramps and a pronounced feeling of bloating are typical. These symptoms disappear as soon as the stomach gets used to the foreign object. In most cases this happens about 3-7 days after the procedure. Some patients also complain of constant pressure or feeling of stomach aches, regurgitation and heartburn for a long time. If the intragastric balloon is constantly causing problems, it should be removed before the end of its term.

Risks and Complications

As with any medical intervention, the installation of the intragastric balloon carries certain risks. The specific risks of the procedure include damage to the teeth, esophagus or stomach by the endoscope. However, they are very rare.

What Should be Done if the Intragastric Balloon Breaks?

Mostly, the risk is that the balloon will break. In this case, the blue colored liquid penetrates the mucous membrane from the balloon into the bloodstream, so that the urine quickly turns blue. The owner of the intragastric balloon should pay attention to this blue color of the urine, as it is indicative of leakage in the balloon.

The damaged balloon should be immediately removed by gastroscopy (endoscopically), as the deflated balloon can cause an intestinal obstruction. If you suspect that the balloon has burst, contact your doctor immediately. If the balloon bursts at night, contact the emergency department of the clinic.

A balloon Filled with Air or Liquid?

The intragastric balloon can be filled with either liquid or air. Some doctors are critical of the balloon being filled with air for many reasons. First of all, the leakage in the air-filled intragastric balloon is not so quickly noticeable, as there is no blue coloring of the urine. This increases the risk of the balloon entering the intestines and therefore the risk of an intestinal obstruction.

It is possible that the weight loss in the case of an air-filled balloon is less because it weighs only 30 grams. On the other hand, a balloon filled with liquid has its own weight of 450-700 grams and thus provides a faster feeling of saturation. In addition, for those traveling by plane, it is important that it is not possible to fly with an intragastric balloon filled with air, as the gas expands at high altitudes.

Prof., Dr. med. Plamen Staikov

Prof., Dr. med. Plamen Staikov

Medical Director, Head physician

Holger Bahn

Holger Bahn

Senior physician

Dr. med. Konrad Stubbig

Dr. med. Konrad Stubbig

Head physician of Anesthesia Department

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