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Intragastric Balloon Fundal or Antral Position Affects Weight Loss and Tolerability

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Abstract

Background

Intragastric balloons (BIB) are routinely used for weight reduction. They should be placed to the gastric fundus, as this place is believed more effective for achievement of satiety and thus weight reduction. The aim of the present study was to evaluate whether the balloon position may affect 6-month weight loss as well as first-month side-effects, i.e. nausea, vomiting, and gastroesophageal reflux.

Methods

From a total of 158 BIB-treated obese individuals, 105 females were found eligible, since the balloon in the stomach was found upon removal in the same position (fundus or antrum) placed at the time of insertion. These subjects were divided into fundus and antral groups. Data related to obesity were recorded on day 0 and upon BIB removal, 6 months thereafter. Data related to transient side-effects (nausea, vomiting, gastroesophageal reflux) were recorded on days 0–3, 7, and weekly thereafter, for 1 month.

Results

BIB placed in the antrum was found to have significantly better results on weight loss parameters, while nausea, vomiting (p = 0.02) as well as gastroesophageal reflux still remained up to the fourth week in a relation to the fundus group. Similarly, the rate of gastric distension was found significantly increased (p = 0.001) during the days 1–3 in fundus group in relation to antrum, followed by a progressive decrease in both groups.

Conclusions

Intragastric balloon placed in the antrum lead to better results in weight reduction but to longer duration of tolerability-related side-effects, i.e., nausea, vomiting, and gastroesophageal reflux.

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References

  1. Nieben OG, Harboe H. Intragastric balloon as an artificial bezoar for treatment of obesity. Lancet. 1982;1:198–9.

    Article  PubMed  CAS  Google Scholar 

  2. Mathus-Vliegen EM, Tytgat GN. Intragastric balloons for morbid obesity: results, patient tolerance and balloon life span. Br J Surg. 1990;77:76–9.

    Article  PubMed  CAS  Google Scholar 

  3. Papavramidis T, Kesisoglou I, Orailoglou V, et al. Mega-obese patients weighing more than 250 kg: a problematic group. Acta Chir Belg. 2009;109:61–4.

    PubMed  Google Scholar 

  4. Mathus-Vliegen EM, Tytgat GN, Veldhu.yzen-Offermans EA. Intragastric balloon in the treatment of super-morbid obesity. Double-blind, sham-controlled, crossover evaluation of 500-milliliter balloon. Gastroenterology. 1990;99:362–9.

    PubMed  CAS  Google Scholar 

  5. Spyropoulos C, Katsakoulis E, Mead N, et al. Intragastric balloon for high-risk super-obese patients: a prospective analysis of efficacy. Surg Obes Relat Dis. 2007;3:78–83.

    Article  PubMed  Google Scholar 

  6. Genco A, Bruni T, Doldi SB, et al. BioEnteric Intragastric Balloon: the Italian esperience with 2,515 patients. Obes Surg. 2005;15:1161–4.

    Article  PubMed  CAS  Google Scholar 

  7. Mathus-Vliegen EMH, Tytgat GNJ. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc. 2005;61:19–27.

    Article  PubMed  Google Scholar 

  8. Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14:991–8.

    Article  PubMed  Google Scholar 

  9. Kotzampassi K, Eleftheriadis E. Intragastric balloon as an alternative restrictive procedure for morbid obesity. Ann Gastroenterol. 2006;19(3):285–8.

    Google Scholar 

  10. Genco A, Cipriano M, Bacci V, et al. BioEnterics Intragastric Balloon (BIB): a short-term, double-blind, randomized, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes (Lond). 2006;30(1):129–33.

    Article  CAS  Google Scholar 

  11. Ballare M, Orsello M, Del Piano M. A case of death after insertion of an intragastric balloon for treatment of morbid obesity. Dig Liver Dis. 2004;36:499.

    Article  PubMed  CAS  Google Scholar 

  12. Nijhof HW, Steenvoorde P, Tollenaar RA. Perforation of the oesophagus caused by the insertion of an intragastric balloon for the treatment of obesity. Obes Surg. 2006;16:667–70.

    Article  PubMed  CAS  Google Scholar 

  13. Ganesh R, Rao AD, Baladas HG, et al. The Bioenteric® Intragastric Balloon (BIB®) as a treatement for obesity: poor results in Asian patients. Singapore Med J. 2007;48:227–31.

    PubMed  CAS  Google Scholar 

  14. Totte E, Hendrickx L, Pauwels M, et al. Weight reduction by means of intragastric device: experience with the BioEnterics intragastric balloon. Obes Surg. 2001;11:519–23.

    Article  PubMed  CAS  Google Scholar 

  15. Evans JD, Scott MH. Intragastric balloon in the treatment of patients with morbid obesity. Br J Surg. 2001;88:1245–8.

    Article  PubMed  CAS  Google Scholar 

  16. Ohta M, Kitano S, Kai S, et al. Initial Japanese experience with intragastric balloon placement. Obes Surg. 2009;19:791–5.

    Article  PubMed  Google Scholar 

  17. Salet GA, Samsom M, Roelofs JM, et al. Responses to gastric distension in functional dyspepsia. Gut. 1998;42:823–9.

    Article  PubMed  CAS  Google Scholar 

  18. Andrews PL, Grundy D, Scratcherd T. Vagal afferent discharge from mechanoreceptors in different regions of the ferret stomach. J Physiol. 1980;298:513–24.

    PubMed  CAS  Google Scholar 

  19. Yuan SY, Brookes SJ, Costa M. Distension-evoked ascending and descending reflexes in the isolated guinea-pig stomach. J Auton Nerv Syst. 1997;62:94–102.

    Article  PubMed  CAS  Google Scholar 

  20. Mundt MW, Hausken T, Samsom M. Effect of intragastric barostat bag on proximal and distal gastric accommodation in response to liquid meal. Am J Physiol Gastrointest Liver Physiol. 2002;283:G681–6.

    PubMed  CAS  Google Scholar 

  21. Marciani L, Gowland PA, Spiller RC, et al. Effect of meal viscosity and nutrients on satiety, intragastric dilution, and emptying assessed by MRI. Am J Physiol Gastrointest Liver Physiol. 2001;280:G1227–33.

    PubMed  CAS  Google Scholar 

  22. Azpiroz F, Malagelada JR. Perception and reflex relaxation of the stomach in response to gut distention. Gastroenterology. 1990;98:1193–8.

    PubMed  CAS  Google Scholar 

  23. Kunz P, Crelier GR, Schwizer W, et al. Gastric emptying and motility: assessment with MR imaging—preliminary observations. Radiology. 1998;207:33–40.

    PubMed  CAS  Google Scholar 

  24. Erzurumlu K, Malazgirt Z, Bektas A, et al. Gastrointestinal bezoars: a retrospective analysis of 34 cases. World J Gastroenterol. 2005;11:1813–7.

    PubMed  Google Scholar 

  25. Zhang RL, Yang ZL, Fan BG. Huge gastric disopyrobezoar: a case report and review of literature World. J Gastroenterol. 2008;14:152–4.

    Google Scholar 

  26. Distrutti E, Azpiroz F, Soldevilla A, et al. Gastric wall tension determines perception of gastric distension. Gastroenterology. 1999;116:1035–42.

    Article  PubMed  CAS  Google Scholar 

  27. Lal S, McLaughlin J, Barlow J, et al. Cholecystokinin pathways modulate sensations induced by gastric distension in humans. Am J Physiol Gastrointest Liver Physiol. 2004;287:72–9.

    Article  Google Scholar 

  28. Levanon D, Zhang M, Orr WC, et al. Effects of meal volume and composition on gastric myoelectrical activity. Am J Physiol Gastrointest Liver Physiol. 1998;274:430–4.

    Google Scholar 

  29. Azpiroz F, Malagelada JR. Physiological variations in canine gastric tone measured by an electronic barostat. Am J Physiol. 1985;248:G229–37.

    PubMed  CAS  Google Scholar 

  30. Tack J, Caenepeel P, Fischler B, et al. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001;121:526–35.

    Article  PubMed  CAS  Google Scholar 

  31. Boeckxstaens GE, Hirsch DP, van den Elzen BD, et al. Impaired drinking capacity in patients with functional dyspepsia: relationship with proximal stomach function. Gastroenterology. 2001;121:1054–63.

    Article  PubMed  CAS  Google Scholar 

  32. De Zwart IM, Haans JJ, Verbeek P, et al. Gastric accommodation and motility are influenced by the barostat device: assessment with magnetic resonance imaging. Am J Physiol Gastrointest Liver Physiol. 2007;292(1):G208–14.

    Article  PubMed  Google Scholar 

  33. Hirsch DP, Mathus-Vliegen EM, Dagli U, et al. Effect of prolonged gastric distention on lower esophageal sphincter function and gastroesophageal reflux. Am J Gastroenterol. 2003;98(8):1696–704.

    Article  PubMed  CAS  Google Scholar 

  34. Van Wijk MP, Blackshaw LA, Dent J, et al. Distension of the esophagogastric junction augments triggering of transient lower esophageal sphincter relaxation. Am J Physiol Gastrointest Liver Physiol. 2011. doi:10.1152/ajpgi.00523. PMID: 2181761.

  35. Papavramidis TS, Michalopoulos NA, Mistriotis G, et al. Abdominal compliance, linearity between abdominal pressure and ascitic fluid volume. J Emerg Trauma Shock. 2011;4(2):194–7.

    Article  PubMed  Google Scholar 

  36. Papavramidis TS, Kotidis E, Ioannidis K, et al. Diaphragmatic adaptation following intra-abdominal weight charging. Obes Surg. 2010;21(10):1612–6. doi:10.1007/s11695-010-0334-5. PMID 21153889.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Aristotle University of Thessaloniki, 45 Agiou Dimitriou str, 54632, Thessaloniki, Greece

    Theodossis S. Papavramidis, Vasilis Grosomanidis, Pyrros Papakostas, Sofia Penna & Katerina Kotzampassi

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  1. Theodossis S. Papavramidis
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  2. Vasilis Grosomanidis
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  3. Pyrros Papakostas
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  4. Sofia Penna
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  5. Katerina Kotzampassi
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Correspondence to Katerina Kotzampassi.

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Papavramidis, T.S., Grosomanidis, V., Papakostas, P. et al. Intragastric Balloon Fundal or Antral Position Affects Weight Loss and Tolerability. OBES SURG 22, 904–909 (2012). https://doi.org/10.1007/s11695-012-0620-5

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  • DOI: https://doi.org/10.1007/s11695-012-0620-5

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