Gastric Balloon

Gastric balloon

A gastric balloon is a silicone balloon filled with liquid or air, inserted into the stomach using gastroscopy. Its size ensures that satiation occurs faster. However, a gastric balloon is only effective when the patient changes their diet and lifestyle habits; it will be removed after six months.

What is a gastric balloon?

Unlike gastric banding and stomach reduction the gastric balloon is a non-surgical measure for obesity treatment. Its purpose is to help obese people to reduce weight.

The gastric balloon is based on a simple working principle: the balloon filled with liquid or air occupies so much space in the stomach that its wearer feels fuller quicker and therefore eats less. The sensation of satiety arises mainly from the expansion of the stomach wall. However, the gastric balloon is only a part of the obesity therapy: the lifestyle habits and the dietary composition play an equally important role.

The gastric balloon is made of a soft silicone that is filled with liquid or air. The gastric balloon is inserted and removed using gastroscopy.

Unlike other weight loss interventions (gastric banding, sleeve gastrectomy, gastric bypass etc.), which are used only in excessively overweight patients, an intragastric balloon is suitable for mildly overweight people (body mass index between 28 and 40 kg/m²). Most commonly, is a stomach balloon applied to people with body weight between 85 and 130 kilograms. In case of very obese patients, the method is sometimes used as a preparation for stomach reduction, in order to reduce the weight before the surgery and thus decrease the surgery risks.

Certain physical and mental illnesses prohibit the use of a gastric balloon (contraindications). These include previous surgeries, diseases or malformations of the stomach or esophagus, gastric ulcers, and addictions such as alcoholism or drug addiction. A gastric balloon is also not recommended in severe eating disorders such as bulimia or other mental illnesses. This method is also not approved for pregnant women. People permanently dependent on the use of anticoagulants are also not allowed to have a gastric balloon installed.

Before a gastric balloon can be installed, the endoscopy of the esophagus and stomach (gastroscopy) is performed. The purpose of this examination is to exclude possible pathological changes, which can make the insertion of a gastric balloon impossible. During the gastroscopy the doctor passes the endoscope through the mouth over the esophagus to the stomach. The endoscope is equipped with a light source and a camera. This allows the doctor to examine the esophagus and stomach for pathological changes.

To insert the balloon, the doctor pulls the endoscope back and pushes the placement catheter containing the balloon into the stomach. When the balloon reaches the stomach, the doctor checks if it is positioned correctly using the endoscope. Then the balloon gets filled using the filling tube with 400 to 700 milliliters of blue-colored saline solution. Then the endoscopist pulls the tube out and checks the correct placement of the balloon again using endoscope.

On an average the procedure lasts for about 20 to 30 minutes and is carried out under a slight twilight sleep (sedation). It can be done in an outpatient setting. However, due to the anesthesia the patient should avoid driving.

After the balloon insertion some patients may suffer from bloatedness, nausea and vomiting. In this case a hospital stay of one to two days is required to intravenously supply the patient with fluids.

The gastric balloon is removed six months after the installation to limit the risk of balloon wall tearing by persistent effect of gastric acid and movement. To remove the gastric balloon a gastroscopy is needed again. During the procedure, the balloon is pierced to remove the liquid. As a result, the gastric balloon loses its firmness and can easily be pulled back through the esophagus. The entire procedure usually takes only a few minutes.

The effectiveness of a gastric balloon can vary greatly from one individual to another. One can expect a weight loss of 10 to 25 kilograms. The weight loss is particularly noticeable in the first three months.

The weight loss success depends largely on how well the patient manages to change their eating habits. Patients consuming a lot of sweet drinks or sweets can even continue to gain weight despite the gastric balloon. Overall, the effectiveness of the gastric balloon is significantly lower than that of a surgical procedure.

The side effects of a gastric balloon are especially distinctive in the first days after insertion. Typically those are nausea, abdominal cramps and intense bloating. These complaints subside as soon as the stomach becomes accustomed to the foreign body. This usually happens three to seven days after the procedure. However, some patients also complain about long-term side effects, such as constant pressure or bloating, belching and heartburn. If the gastric balloon is permanently causing problems, it should be removed early.

Like any other medical intervention, the gastric balloon installation is also associated with certain risks. The intervention specific risks include damage to the teeth, esophagus or stomach caused by the endoscope. However, these occur very rarely.

In principle, there is also the risk of the balloon rupture. In this case blue-colored liquid leaks from the balloon and gets absorbed into the blood via the mucous membrane. It causes the urine to quickly turn blue. The wearer of the balloon should pay attention to the blue color of the urine as it indicates a leak in the device.

A damaged gastric balloon must be removed immediately using gastroscopy (endoscopically), as the deflated balloon can cause intestinal obstruction. If you suspect a bursting of the gastric balloon you should immediately consult a physician. If the balloon has ruptured at night, you should immediately head for a hospital ER.

A gastric balloon can be filled with either liquid or air. Some doctors criticize the air-filled option for several reasons: firstly, one notices a leak in the air-filled gastric balloon not so quickly, because the urine does not become blue. This also increases the risk of a balloon passing into the intestine and thus causing intestinal occlusion. The weight reduction in the air-filled balloon is also not that effective, as it only weighs about 30 grams. The liquid-filled gastric balloon, on the other hand, weighs 450 to 700 grams and thus provides a faster feeling of fullness. It is also important for air travelers: gases expand at high altitude, thus they must avoid flying with an air-filled gastric balloon.

The cost of a intragastric balloon differs considerably depending on the treatment case and the doctor. As a rule, a gastric balloon costs between 1500 and 4500 euros. Interested parties should not only pay attention to the price, but also to the quality of treatment. One can assess the quality exchanging experiences with other patients, or using physician's evaluation portals. The personal impression from the treating physician and the practice gained in the first interview should also be incorporated into the overall judgment.

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