The gastric balloon placement is a reversible procedure wherein a silicone balloon is inserted into the stomach and inflated with liquid. This balloon occupies space within the stomach and reduces the amount of food it can hold. This makes the patient feel full even with small meals. Reduced apetite also ensues.
The gastric balloon is inserted through the mouth and therefore does not require any incisions or surgery. This is in contrast to gastric banding or gastric bypass procedures. The latter are surgical procedures and are much more invasive, however, on the other hand they do result in increased weight loss.
Who is eligible for a gastric balloon?
Gastric balloons are not inserted for aesthetic reasons alone. Patients considered for intra gastric balloons are those who are seriously overweight. Usually the Body Mass Index (BMI) is taken into consideration. This is the ratio of the weight over the height (in metres squared). A good candidate for an intra gastric balloon is someone who is obese or excessively overweight and has repeatedly tried to lose weight through sensible exercise regimes and by adhering to a controlled, weight loss diet. The BMI needs to be above 35, or else is above 30 and is associated with conditions that worsen in obesity such as high blood pressure, diabetes, back pain and arthritis or heart disease.
What does the procedure involve?
The patient is initially assessed by the consultant to see whether he or she is eligible for the procedure. A qualified dietician, who will also need to follow the patient whilst the balloon is in place and also after it is removed, will also need to be seen.
The gastric balloon is carried out as a day procedure. The patient is admitted to the day ward after being starved for at least 12 hours.
The balloon is inflated after a gastroscopy, which is performed to make sure that there are no stomach conditions, such as a large hiatus hernia, that can preclude the safe insertion of the balloon. This gastroscopy is performed under sedation. The balloon is then inserted in the deflated state through the mouth. It is next inflated through an attached catheter.
What is new about the intra gastric balloons being used today?
Gastric balloons have been used for several years.
The new generation balloon is adjustable and its size can be decreased or increased whilst it is still in the stomach. This is done through a simple gastroscopy. This is important as patients often stop losing weight after a few months. Now the balloon can be inflated further and the patient can start losing more weight.
The new adjustable balloon has a specially designed uncrushable catheter system which curls into shape when it reaches the stomach. Even if the balloon should lose all its fluid, this catheter will prevent it from travelling out of the stomach from where it can be safely recovered during a gastroscopy. Patients who find that their weight loss has stopped, or who have other reasons to suspect that the balloon has deflated, can ask their physician to perform a simple x-ray or ultrasound examination to verify the situation.
This special adjustable feature provides an added advantage to assist weight loss. All this translates into greater weight loss for the patient. Whilst the average weight loss to be expected from the old balloons would be around 15 kgs, with the new balloons, patients can lose an average of 35 kgs over a year.
What side effects are there?
The main side effects are nausea and vomiting and /or abdominal pain. These usually occur within the first 3 or 4 days after inserting the balloon and almost invariably stop after this period of time. The new balloons may be deflated partially until the stomach adapts if the symptoms are intolerable.
Deflation of the balloon with migration down into the intestine is now much less likely with the new balloons.
The gastric balloon is an aid to reasonable diet and lifestyle modifications. It makes losing weight much easier but will not work without a diet. Patients can expect to lose about 35 kgs over a year.
The weight loss is maintained even after the balloon is removed though patients can expect to regain a few kilos. At this stage the dietician’s role is particularly important in order to maintain the weight loss achieved.