Intragastric Balloons

A frequently used method that does not alter the stomach anatomy.

Intragastric balloons

Obesity is a complex metabolic disorder that is associated with several other health conditions such as cardiovascular disease, diabetes, and hypertension. There are many therapies available that help an individual to lose weight. These may include medical treatment, endoscopic treatments and bariatric surgical procedures.

Although bariatric surgery is proven as an effective treatment for obesity patients, it carries some disadvantages including:

  • Cost
  • Post-operative risks
  • Permanent changes in the anatomy of the stomach
  • Excluded for class I obesity (BMI 30.0 – 34.9 Kg/m2).
  • Invasive procedures
  • Life-long side effects

  • Intragastric balloons - A better alternative +

    Endoscopic therapies are better alternatives for obesity treatment, of which intragastric balloons are more frequently used. They act as an intermediate solution between medical treatments and bariatric procedures for obesity. The major advantage of intragastric balloon is that it does not lead to any changes in the gastrointestinal region and preserves the anatomy of the stomach. Other advantages of the procedure include:

    • Minimally-invasive
    • Simplicity and safety
    • Applicability to different degrees of obesity
    • Efficacy

  • How does this help lose weight? +

    Intragastric balloons can be placed in the stomach using endoscopic procedures. Once inside the stomach, they occupy the space in the stomach reducing its capacity. As a result, the patient feels full quickly, which ultimately reduces the amount of food they can consume. The satiety can be also related to the mechanical intragastric distention, enlargement of the stomach due to the balloon which is similar to that achieved through food intake.

    Significant weight loss is achieved with the help of intragastric balloons. They can also reduce the person’s risk for potential and serious obesity related comorbidities such as:

    • Type 2 diabetes
    • Hypertension
    • Cardiovascular disease
    • Sleep apnea
    • Osteoarthritis
    • Cancer

  • Patient eligibility +

    Intragastric balloons may not be the right choice of treatment for all the persons with obesity. The physician may check for the suitability of the procedure by a through screening process. The following are the considerations for a person to be an ideal candidate for intragastric balloon treatment.

    • BMI between 30 – 40 Kg/m2
    • Willingness to be committed with lifestyle and behavioral changes
    • Obese person who is unwilling to undergo a surgery

    A person with a history of abdominal or esophageal surgery, inflammatory disorders like stomach ulcers or inflammatory bowel disease, or with a large hiatal hernia are not considered to undergo the treatment.

  • Pre-procedure +

    The person may be recommended to undergo certain laboratory tests and examinations before the procedure. Specific instructions regarding changes in medications or food restrictions that should be followed before the procedure are specified. The procedure is usually done in outpatient unit without or with mild anesthesia.

  • During the procedure +

    The procedure for different types of intragastric balloons slightly differs. Currently there are three types of intragastric balloons that are approved by FDA. They include Orbera intragastric balloon, Obalon intragastric balloon and TransPyloric Shuttle Delivery device. Other types of intragastric balloons include silimed balloon, heliosphere bag, elipse and spartz.

    Orbera intragastric balloon: During the procedure, a thin catheter tube loaded with an elastic silicon balloon is advanced through the mouth into the stomach. Later, an endoscope is advanced in the same way to visualize the balloon. Once the balloon is placed in the position, it is inflated using saline (450-700 ml). After completing the procedure, the catheter and endoscope are removed carefully.

    Obalon intragastric balloons: An obalon balloon is packed in a capsule with a thin catheter attached to it. During this procedure, the balloon is delivered into the stomach by making the patient to swallow the capsule, while holding the other by the physician. An ultrasound system is used to ensure that the capsule is positioned in the stomach. The balloon is then inflated with gas (250 ml of nitrogen) through the catheter. A maximum number of three balloons can be placed, in a period of twelve weeks (one for every four weeks).

    TransPyloric Shuttle Delivery Device: During this procedure, the patient is under mild sedation. This procedure is a minimally invasive endoscopic procedure that is involved in placing a Transpyloric shuttle (TPS) into the patient’s stomach. Once the physician ensures the correct placement of TPS, it is inflated with a TPS controller with 900 ml of saline. This helps the TPS to take the shape of a smooth large balloon that is connected to a smaller balloon with the help of a tether. The large bulb remains in the stomach and the smaller balloon either remains in the stomach or crosses it to enter the small intestine.

    The procedures may be completed within 15 to 30 minutes. The person may have to stay for few hours after which he can return home normally.

  • Post-procedure care +

    The person may feel nausea, vomiting and abdominal cramps which will be resolved on its own gradually within two weeks. The person may have small amounts of liquid after six hours of the procedure. The liquid diet should be continued for a week. During the second week, the person may consume soft or semi-solid foods. He/she may have regular diet after three weeks of the procedure. But it is important to follow the diet modification as suggested by the physician or nutritionist.

  • Endoscopic removal of intragastric balloons +

    Intragastric balloons are allowed to stay in the stomach for a period of six months after which they have to be removed using an endoscope. During the procedure, slight sedation may be given, but the person will be in conscious state. The physician sends a special endoscopic tube attached with camera through the mouth into the stomach. With the help of it, the physician deflates the balloon using a special tool. The balloons are then removed along with the endoscope. This procedure takes about 15 to 30 minutes.

  • Outlook +

    A person may lose about 10-15 percent of his body weight with the help of intragastric balloons during first six months. Intragastric balloon is a temporary weight loss treatment that helps a person to lose weight in a short period of time. The long-term success of the procedure requires commitment towards lifestyle and dietary changes. Like any other procedures, intragastric balloon may help to achieve significant weight loss, and help improve or resolve conditions often related obesity.

    References

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917609/

    https://www.mayoclinic.org/tests-procedures/intragastric-balloon/about/pac-20394435

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763559/

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