Gastric Balloon

The gastric balloon procedure may be an option for people with a BMI (body mass index) between 30 to 40 kg/m². In some cases, people with a BMI as low as 27 kg/m² may qualify. This means gastric balloons may be able to help people who are not medically eligible for weight loss surgery. They may also be an option for people who are not ready for more permanent weight loss surgery, such as gastric bypass. You can’t use gastric balloons if you previously had stomach or esophageal surgery.

Typically, doctors require you to try losing weight with diet and exercise first. You will also need to continue these strategies during and after gastric balloon therapy. Diet, exercise, and behavior modification are vital for long-term weight loss success. Gastric balloon without a commitment to lasting lifestyle changes will only result in temporary weight loss.

Your commitment to a healthy lifestyle and the weight loss you achieve with the help of a gastric balloon can decrease your risk of serious obesity-related health problems including cancer, kidney disease, osteoarthritis, sleep apnea, and type 2 diabetes.

A bariatric surgeon or gastroenterologist may perform gastric balloon procedures. Bariatric surgeons concentrate on treating obese people who have not had success with medical weight loss programs. Gastroenterologists specialize in conditions of the digestive system. These doctors will work with a team of healthcare providers to deliver care with a gastric balloon procedure. This includes registered dietitians and other weight loss specialists.

Gastric balloon does not involve an incision. It is not gastric balloon surgery. Instead, doctors place all types of gastric balloon through the mouth, gently passing them down through the esophagus into the stomach.

Obera™ requires endoscopic placement. You will receive sedative medicines for the procedure. Your doctor will use an endoscope to place the balloons in your stomach and fill them with saline. An endoscope is a thin, lighted instrument with a camera at the tip. Your doctor can view the inside of your stomach and use specially designed instruments to complete the procedure. It takes about 30 minutes.

Obalon^® is a capsule you swallow with a large glass of water. The capsule contains the balloon and has a catheter attached to it. After you swallow the capsule, the other end of the catheter remains hanging outside your mouth. The procedure does not require sedation, but you will need X-rays to verify the capsule location in your stomach. Once your doctor is sure the capsule is in place, he or she will inflate the balloon with gas through the catheter. A second X-ray will show the inflated balloon. They your doctor will unfasten the catheter from the balloon and pull it out through your mouth.

Your doctor will place a second Obalon^® balloon after at least two weeks have passed since the first balloon placement. Similarly, a minimum of two weeks must pass before your doctor can place a third balloon.

All gastric balloons must be removed six months after placement. Removal of gastric balloons is an endoscopic procedure. For the Obalon^® balloon system, removal also takes place six months after the first balloon placement.

Choosing a doctor with documented experience and expertise performing gastric balloon procedures will improve your chances of success. These factors also affect whether the gastric balloon is safe or not. All medical procedures, including weight loss procedures carry risks and potential complications.

Most gastric balloon procedures are successful, but potential complications and side effects include:  

• Abdominal pain, which may occur in about 50% of people

• Acid reflux and heartburn, which may require medicine

• Early removal for intolerance of the balloon

• Nausea and vomiting are common right after balloon placement. Your doctor may use medicines to treat these side effects, which tend to improve after several days.

• Stomach cramping or bloating

Rare complications can also occur, including deflation of the balloon. This may allow it to move or migrate into the intestine, which can result in bowel obstruction or blockage. Perforation of the stomach or bowel can also occur. With saline-filled balloons, acute pancreatitis is another rare, but very serious potential complication. These complications may require additional surgery or procedures. 

You can reduce your risk of certain complications by:

• Following your doctor’s activity, dietary and lifestyle restrictions and recommendations before and after your surgery

• Informing your doctor if you are nursing or if there is any possibility of pregnancy

• Contacting your doctor right away in case of bleeding, fever, increase in pain, or other unexpected symptoms

• Telling all members of your care team if you have medication allergies

Your team will give you specific preparation instructions for the gastric balloon procedure. In general, you can prepare by:

• Explaining your medical history, known allergies, and medications, including prescriptions, over-the-counter drugs, dietary supplements, and vitamins.

• Arranging a ride home

• Having antinausea and antireflux medicines ready at home

• Following a healthy diet and exercise plan. Your team may ask you to keep logs for diet and exercise before your procedure.

• Not eating or drinking before your procedure as directed. Having an empty stomach helps decrease nausea and other problems during balloon placement.

• Stopping smoking as soon as possible

• Taking or stopping medications exactly as directed. Your doctor will give you instructions for taking your specific medications and supplements.

Making a list of questions can help you remember everything you want to ask your doctor. Questions you may want to ask include:

• Why are you recommending this specific type of gastric balloon for me?

• How much does gastric balloon cost? What financing options do you offer?

• How long will the procedure take? When can I go home?

• What restrictions will I have after the procedure? What kind of assistance will I need at home?

• When can I return to work and other activities?

• How will you manage any nausea or vomiting?

• When should I follow up with you?

• How should I contact you after hours if I have a problem?

• What symptoms should prompt me to seek immediate medical care?

Knowing what to expect makes it easier to plan and prepare for a successful recovery.

Gastric balloon is an outpatient procedure. If you have endoscopic placement, you will need time to recover from the sedation. Afterwards, you can go home. You will be on a liquid diet right after the procedure. Generally, this continues for a 1 tor 2 weeks. Gradually, you will transition to a soft diet and then to solid food. This can take 3 to 6 weeks. You will work with a dietitian to ensure you are getting enough protein, vitamins, and other nutrients. The dietitian will also help you with foods you should avoid.

You will need to chew your food thoroughly and eat slowly with a gastric balloon. You also need to stop eating at the first sign of fullness. Having hiccups, nausea or heartburn after eating may mean you need to slow down and pay attention to feelings of fullness.

Your doctor will let you know when it is safe to exercise. Remember, diet and exercise are vital to the success of your gastric balloon. Remaining committed to a healthy lifestyle after removal will help ensure long-term success.

Right after balloon placement, you may feel some discomfort. You should tell your doctor if you have pain. It may be a sign of a complication.

Call your doctor’s office during normal business hours if you have questions between follow-up appointments. Your doctor may also give you instructions for after-hours concerns. Call your doctor right away or seek immediate medical care if you have:

• Change in urine color to blue-green, which may mean the balloon has leaked

• Constipation or inability to pass stool or gas

• Fever

• Loss of the sense of stomach fullness or increased hunger

• Pain that does not go away

• Pain that is different from the initial discomfort right after balloon placement

• Severe nausea, vomiting, cramping or diarrhea

• Sudden abdominal pain or swelling of the abdomen

Gastric balloon may help you reach success with your weight loss goals. It is a procedure for obese people who have not had success with diet and exercise alone. Because you do not have to be morbidly obese to qualify for gastric balloon, it can be a good option for people who are not candidates for weight loss surgery.

If you remain committed to healthy diet and exercise habits, gastric balloon can help you lose approximately 10 to 15% of your body weight. This will significantly reduce your risk of obesity-related health problems.