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    Intragastric Balloon for Weight Loss/ Endoscopic Balloon

    Intragastric balloon placement is a comparatively newer procedure for weight-loss. Here, an inflatable saline-filled silicone balloon is placed in your stomach. This balloon fills a considerable space in your stomach and decreases the capacity of food which you can eat. The stomach feels fuller, and the diet slowly reduces without compromising with the absorption of essential nutrients, as compared to bariatric surgery.

    Q. What is gastric balloon procedure? How is Intragastric balloon placed?

    The intragastric balloon procedure is an outpatient procedure, usually done under sedation. During this procedure, first the doctor advances a thin tube (catheter) loaded with the deflated intragastric balloon into your stomach. Next, the doctor advances an endoscope — a thin and flexible tube with a camera attached to one end— through mouth, esophagus and into your stomach. Once correctly put, it is filled with 400-700 ml of clear fluid/ normal saline, according to the stomach capacity..
    Like other weight-loss procedures, an intragastric balloon requires commitment to a healthier lifestyle. You need to make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of the procedure. This is approximately 30 minutes procedure. After completion, patient is observed in endoscopy suits for 1-2 hours and then can be discharged.

    Indications of Intragastric Balloon/ When to go for Endoscopic Balloon?

    Consider the intragastric balloon procedure if you have concerns thoroughly worked to reduce your weight by both diet and exercise, yet they haven’t worked for you. Main use lies in reducing the weight and controlling associated disease which accompany obesity, like
    • Heart disease or stroke
    • Gastroesophageal reflux disease (GERD)
    • High blood pressure and Type 2 diabetes
    • Obstructive sleep apnea
    • Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH)
    • Fatty liver
    • PCOD

    Q. Who can undergo intragastric balloon procedure? Is intragastric balloon safe?

    It is very important to ensure that either balloon placement or bariatric surgery is attempted only after patient has tried to lose weight by improving your diet and exercise habits. Once this criteria is fulfilled, following people can opt for this:
    • When body mass index (BMI) is between 30 and 40kg/m2
    • Patient is fully motivated to commit to healthy lifestyle changes, follow diet, perform mentioned exercise. The patient should have access to regular medical follow-up and compliant to behavioral therapy.
    • You should not have any previous stomach or esophageal surgery
    • Intragastric balloon can be put in people who have contraindications to bariatric surgery due to anesthesia related risks; such as uncontrolled blood sugar and blood pressure

    Advantages of gastric balloon

    • It is reversible bariatric procedure, unless like surgery where a major part of bowel is either removed or by- passed and is irreversible.
    • It shows results slowly over 3- 6 months, during which body gets time to acclimatize to the change.
    • Usually removed after 6 months but can be removed early too.

    How to prepare for Intragastric balloon/ What are the precautions before Intragastric balloon placement?
    1. Do not eat or drink anything 6 hours before undergoing endoscopy.
    2. Dress comfortably and wear loose clothes.
    3. Come with an attendant to arrange for a ride back home.
    4. If you have any co-morbidities (like hypertension, diabetes, heart condition or bleeding disorder, do inform doctor beforehand). If you are consuming any chronic medicines, then they need to be reviewed weather to continue or not before the procedure.

    Care after intragastric balloon procedure

    • Drink clear liquids only on the day of procedure.
    • Only liquids should be consumed for 2 weeks post surgery, eg milk, soups , protein shakes
    • Visit your doctor for a follow-up appointment one week later
    • During 3rd and 4th week, semi solid and pureed food can be taken, which is to be introduced gradually. Week 5 onwards, you can have solid meals, but make sure to replace one meal at a time and begin slowly.
    • Deep breathing with walking can be done for one moth post procedure, but no abdominal exercises are allowed.

    Contraindication for Intragastric balloon

    • Prior gastrointestinal or bariatric surgery
    • Bleeding from upper GI tract
    • Ulceration in stomach or duodenal ulceration
    • Hiatal hernia > 5 cm
    • Coagulation disorder
    • Drugs/ Alcohol abuse
    • Cancer of gut, eg stomach, bowel, esophagus
    • Inflammatory bowel disease, such as Crohn’s disease.
    • Non- motivated/ psychiatric patient

    Risks/ Side effects of Intragastric balloon/ Is gastric balloon safe?

    • Pain and nausea – common, respond to simple antiemetics and pain medicines
    Other rare problems are:
    • Balloon deflation
    • Overinflation,
    • Acute pancreatitis,
    • Ulcers or perforation

    Frequently Asked Questions:

    Q. Which gastric balloon is best?
    A. Three balloons are available in market ,ReShape, ORBERA, Obalon Gastric Balloons. All of them are FDA approved for patients with a BMI of 30-40. Orbera is the most commonly used one. All balloons have their typical features, which need to suit individual patient. The choice of balloon will be done by your doctor, according to patient profile.

    Q. How much does gastric balloon cost?
    A. Depending on type of balloon, the average cost of procedure will be approximately 1.2 – 2 lacs

    Q. Diet for Intragastric balloon
    A. Mentioned above

    Q. Gastric balloon v/s sleeve bariatric surgery: which is better for weight loss?
    A. Both the procedures have their own advantages and disadvantages and specific patient profiles which are mentioned as above.

    Q. When will the Intragastric balloon be removed?

    A. Usually removed after 6 months. However, its size may be increased or decreased via inflation or deflation at the 3 months follow up.
    If the balloon is left for more than 6 months, there are chances of spontaneous deflation or migration.
    This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition