Shamail Zafar, Israr-ul Haque, Mehrin Farooq, Hira Bashir, Gulsena Masood Khan, Nusrat Ullah Chaudry.
Intra-Gastric Balloon for Weight Loss: Preliminary Analysis of Efficacy & Tolerability.
Pak J Med Health Sci Jan ;8(1):224-9.

Aim: To assess the efficacy and tolerability of intragastric Balloon Placement in association with restricted diet that is being used for the short-term treatment of morbid obesity. Study design: Cross sectional Study Place and duration of study: Department of Medicine Ghurki Trust Teaching Hospital, between June 2009 and December 2011. Methods: Intragastric balloons were placed in 30 patients with obesity. The inclusion criteria were obesity (BMI >35 kg/m2), the presence of obesity-related problems, and failure with conventional treatments for at least 6 months. Balloon placement was done on an inpatient basis, under Propofol anesthesia. Inflation of balloon varied between 600-650ml saline, depending upon stomach’s capacity. Intravenous antiemetic, PPI and spasmolytic drugs were given to control post-insertion nausea for 24 hours, and oral medication were administered later on. A standard 1200 Kcal diet was prescribed after dietitian's consultation. Balloon was kept for six months and then removed endoscopically. Any morbidity, complications, BMI and weight loss were evaluated. Data were expressed as mean ±SD. Results: 30 patients (16 M, 14 F) with mean age of 33±8 years were included after pre-procedure evaluation. 28 patients were eligible for review after 6 months; Mean weight loss was 21.2±9.05 (3-56 kg). Mean initial weight was 125.8±37.5 (102 to 236 Kg) and it dropped to 104±25.9 (82 to 180Kg) (p<0.05) six months later. Mean pre-procedure BMI was 43.6±3.6 (37.6 to 50 kg/m2) while 6 months later it dropped to 37.7±4.2 (p<0.05). 100% of the patients complained of severe nausea, vomiting, epigastric discomfort and retrosternal burning, resulting in early removal of the balloon at day 7 in two patients. In 82% patients, esophagitis (grade III to IV) and diffuse gastric erosions were present at the time of withdrawal of balloon. Conclusion: Intragastric balloon is associated with successful weight loss. Although severe morbidity can occur, but it provides a good means of weight reduction in conjunction with dietary measures and exercise.

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