1. What is an intragastric balloon?
The intragastric balloon system (IGB) is a soft and expandable silicone balloon that a specialised physician introduces into the stomach deflated through the mouth aided by endoscopy and under sedation.
Intragastric balloon (IGB) increases the patient´s feeling of satiety
2. How does it work?
The balloon occupies part of the stomach and patients do not feel as hungry because they feel “full”. To make it simple, the balloon increases the patient’s feeling of satiety.
The IGB is designed to facilitate compliance of a supervised diet and modification of diet habits.
The balloon is inserted into the stomach through the mouth without surgery.
The endoscopist and specialist in digestive surgery first visualises the inside of the stomach through a camera or gastroscope and if no anomaly is found, the balloon is inserted through the mouth and down the oesophagus until the stomach is reached.
Once in position, the balloon is insufflated with saline solution. Once filled, the balloon will be too large to go down into the intestine and will float freely inside the stomach.
The time needed to insert the balloon varies, but on average it takes no more than 20 to 30 minutes. After that time, the doctor will make sure the device is in the correct position and if everything is in order, the patient will be allowed to go back home after a few hours.
By consensus among manufacturers and specialists, the ballon must remain up to 6 months in the stomach, after which time it will be removed.
Removal of the ballon is in the same way it was placed, ie through the esophagus and mouth by a specialist in digestive tract by gastroscopy.
3. Who can benefit from the intragastric balloon?
The aim of the IGB system is to help patients with a body weight 40% above the ideal weight loose their excess weight. In an adult patient, that 40% could very well be loosing between 20 and 25 kilos.
Furthermore, the IGB system is particularly useful in people considered obese or at greater risk to undergo serious surgical procedures. The use of this system to loose weight prior to surgery can reduce surgery-associated risks.
4. Why will you loose weight?
It is important to understand that the intragastric balloon system is a device that helps loose weight because it makes the patient feel full, thus reducing the daily intake of food. It should therefore be used in combination with a diet supervised by a doctor and a programme intended to change the patient’s eating habits. Thus, the weight loss will depend on the strict adherence to the diet which will be help by the feeling of satiety caused by the intragastric balloon.
5. How much weight will I loose?
The approximate weight loss for any obesity treatment should be 1 kg per week. The weight loss will depend on factors such as the time the balloon remains in the stomach (a maximum of 6 months) and the weight loss pace of each patient.
It is possible that you do not loose any weight or little weight during the time the balloon is inside your stomach. It is also possible for you to loose weight radically in a way that is unhealthy for your body. You should always discuss these possibilities with your doctor.
6. Will I regain the weight once the balloon is removed?
Your chances of keeping the weight off will be greater after the balloon is removed if you maintain the healthier eating habits you followed during the time the balloon was in.
7. What may feel unpleasant effects of intragastric balloon system?
The presence of the balloon inside the stomach is very likely to cause nausea or vomiting for a few days after the insertion. Your doctor can prescribe medication to relief these potential side effects.
8. Are there any risks associated with the use of the intragastric balloon?
As with any medical procedure, there is a risk of unexpected, unknown or adverse reactions to the medications used and to the type of procedures employed. This risk can vary depending on each individual.
The intragastric balloon is made of a special, acid-resistant silicone. If the balloon deflated before the scheduled time, the colorant inside would change the colour of the urine.
This situation is highly unlikely and should it occur, the reduced size of the deflated balloon would allow it to be passed through the intestine and excreted naturally from the body.
Very rarely the balloon needs to be removed surgically. If you suspect that the balloon has deflated, please contact your doctor immediately.
As with other gastric procedures, there is the risk of damage to the walls of the digestive tract or stomach, either due to direct contact with the instruments employed whilst inserting the balloon, due to the actual balloon or due to the excessive production of acid by the gastric wall.
Possible consequences are the development of ulcers, bleeding, pain or perforations. Such complications can require a medical or surgical intervention.
You should discuss the procedure with your doctor who will be happy to answer any of your questions so that you are well informed and can assess the risks and benefits of this system.
- According to the World Health Organisation, over 1000 million people in the world are overweight and, of these, at least 300 million are obese. Moreover, a recent study has demonstrated that obesity causes more health problems than smoking or alcohol. The increase in obesity-related chronic diseases is similar to that of a 20-year ageing.
Obesity is usually managed from an endocrinology point of view, by changing the diet and/or prescribing drugs, or by employing a surgical approach to the problem. However, there are also other techniques available to the obese patient.
As described in other sections, a technique that is becoming increasingly popular and that affords excellent results is the non-surgical implantation of an intragastric balloon through the mouth into the stomach via endoscopy.
- According to Dr Gontrand López-Nava, a digestive system specialist and head of the department of Digestology and Endoscopy of the Hospital Monte Príncipe in Madrid, the intragastric balloon is a silicone device that occupies part of the stomach making the patient feel full. It is introduced into the stomach without surgery and the procedure lasts no more than 30 minutes, allowing the patient to return home after two or three hours. The technique is based on a gastroscopy that is performed under sedation (no general anaesthesia). A flexible tube with a TV camera is inserted through the mouth to visualise the gastric cavity and verify that it is normal.
After the presence of lesions is ruled out, the balloon is slowly introduced and, once in place, it is filled with a sterile solution to occupy part of the gastric cavity. Once in place and filled the balloon is left t float around the stomach freely for six months.
“The intragastric balloon is a device that restricts the capacity of the stomach, provoking a feeling of satiety before eating. Its objective is to make the patient loose weight at the pace the body can assimilate such weight loss in the best manner. A reduction of body weight of up to 30 kg can be achieved in a six month period. The implantation of the device enables the patient to loose weight progressively and in a controlled manner, with practically no side effects. The patient can lead a normal life, including exercise from the day after the implantation”.
"The balloon is intended to help maintain a well balanced diet in basic elements, vitamins and minerals. The diet will be personalised according to the body mass index and body composition, and coordinated by a group of experts composed of endocrinologists, digestive specialists, psychologists and nurses”, explained Dr López Nava. The balloon is rejected in very rare instances (1.3% of the cases). It is normal for the patient to experience some nausea and discomfort during the next five days after the introduction of the balloon. However, after this period, these symptoms will subside. Results are visible from the first week, since the device prevents the individuals from eating their usual amounts of food to which their stomach were used . Since less food is taken, the patient starts to loose weight gradually in a controlled manner. No special medical follow up is required to check the nutritional aspects of the treatment.
At present, the team of Dr López-Nava, has treated over 250 patients, with obesity problems that range from moderate to very severe, “without any severe complications being reported in the implantation and with a tolerance rate to the balloon above 97%”, said Dr Caballero, a renowned member of the service of the Digestive Surgery department of Hospital San Rafael in Madrid.
The intragastric balloon is a valuable tool for the obese patient, as it resolves obesity problems successfully with decreased risk or as a complement to classic surgery in very severe cases.
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