Swallowable Intra Gastric Balloons
Do swallowable intra gastric balloons have any extra advantage over regular balloons?
Intra Gastric Balloon insertion is an endoscopic non surgical procedure to treat obesity. In general balloons are indicated for those people whose BMI is between 27.5 and 32.5 kg/m2, and are not able to lose weight by lifestyle modifications. Balloons can be considered even in those whose BMI is greater than or equal to 32.5 kg/m2 who need bariatric surgery but are afraid to undergo the surgery. Generally it is considered in patients with 05 to 10 kg overweight.
Swallowable balloons are recent addition and the companies claim that there is
no need for endoscopy
no need for anaesthesia
no need for surgery
How far these claims are valid?
And what is being hidden?
In swallowable balloons, patient swallows the ballon which is in the form of a pill. Its position is confirmed by the fluoroscopy and balloon is filled upto 400 to 550 ml. Anaesthesia is not required for this balloon insertion. After 16 weeks, balloon spontaneously degrades and passes out through the anal canal.
For any balloon procedure it is necessary to do upper gastrointestinal endoscopy, to make sure that there are no contraindications for balloon insertion such as gastric ulcers, gastritis, large hiatal hernia or reflux esophagitis. Saying that no endoscopy is required is actually misleading the patients.
Weight loss is because of food restriction. It doesn’t change the hormones controlling body fat. So it is very inferior compared to bariatric surgeries. So any balloon procedure can’t replace bariatric surgeries. Those who require bariatric surgeries don’t actually benefit from balloons.
No anaesthesia is required but what about radiation? Fluoroscopy has a radiation equal to 75 to 300 Chest X Rays. We are exposing the patient to unnecessary radiation. Anaesthesia is better than radiation.
What are the results –
IGB combined with lifestyle modifications can result in 5 to 10% of the total body weight loss. To improve the outcomes Oral Semaglutide can be added. On average patients lose 05 to 10 kg of the weight. And some people may not lose weight at all after balloon insertion. And even some more will gain weight even in the presence of balloon.
Is it more effective than regular balloon?
In general balloons are very less effective, compared to bariatric surgeries. And swallowable balloons are even less effective because the volume is relatively less. Ballons are generally for temporary weight loss. Even if it is swallowable balloon, it is not advisable to do the procedure without prior upper gastrointestinal endoscopy to rule out any contraindications. And patient is exposed to unnecessary radiation.
Endoscopic Sleeve Gastroplasty is a better choice compared to Intra Gastric Balloon if anyone is afraid of surgery.
Its volume is 400 to 550 ml. Regular balloons upto 800 ml.
It stays only for 4 months. Regular balloons stay for 6 months to 1 year.
There is radiation equal to 75 to 3000 Chest X Rays with Fluoroscopy (Needed for this balloon). No radiation with regular balloons.
At the end any balloon is ineffective as it don’t change hormones
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Dr. Amar Bariatric & Metabolic Center,
Hyderabad, India
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