Pre-op and Post-op Instructions
Please watch this video and read the instructions to prepare for your gastric balloon!
IMPORTANT: You will need a driver, you cannot drive yourself home from the procedure!
First, an endoscopy is done to inspect the inside of your stomach. This is done under sedation, so you won’t be awake!
Next, the deflated balloon is guided into your stomach, attached to a catheter with a guidewire.
The guidewire is removed, opening up the channel in the catheter so that saline can be injected.
The balloon is inflated with saline and the catheter is disconnected, leaving only the balloon behind.
Six months later, the another endoscopy is done, the balloon is punctured with a catheter and the saline is removed, followed by the balloon.
The FDA has approved the ORBERA™ and ReShape Duo intragastric balloon weight loss procedures in the United States.
The intragastric balloon is a new weight loss procedure which involves placing a soft, deflated, silicone balloon inside the patient’s stomach through the use of an endoscope. Placement of an intragastric balloon is a non-surgical, minimally invasive procedure that is performed on an outpatient basis. The procedure takes only about 20-30 minutes and requires minimal recovery time. The intragastric balloon has been approved for use outside the US for many years. Several hundred thousand of these devices have been placed world-wide.
Once the intragastric balloon is endoscopically inserted, the empty balloon is filled with sterile saline. The balloon takes up space in the patient’s stomach, limiting food intake and reducing feelings of hunger. The balloon remains in place for 6 months, during which time the patient should participate in a behavior modification program and a medically supervised diet. After 6 months, the balloon must be removed and requires another short endoscopic procedure.
Qualifications for the Intragastric Balloon Procedure
The Intragastric Balloon Procedure is ideally suited for patients who:
- Have a BMI of 30-40 with or without a weight-related comorbidity
- Have a BMI over 40 but not interested in surgery (off-label)
- Have been unable to achieve their weight loss goals through diet and exercise.
- Are uncomfortable with, or ineligible for, other types of weight loss surgery.
- Are willing to participate in a medically supervised diet and behavior modification program.
Off-label means usage of the device outside the indications for which the FDA approved it. This is allowed in the US as long as the patient is informed of the off-label use and desires to proceed.
Conditions that would prevent a patient from having the Intragastric Balloon Procedure include:
- Previous weight loss surgery
- Any inflammatory disease of the gastrointestinal tract
- Potential upper gastrointestinal bleeding or other congenital anomalies
- Large hiatal hernia or structural abnormality in the larynx or esophagus
- Any condition that would hinder endoscopy
- Unwillingness to participate in the supervised diet and behavior modification program
- Drug or alcohol addiction
- Pregnancy or breastfeeding
- Past or present psychological disorders
- Regular use of blood thinners
The intragastric balloon is ideal for patients who are moderately overweight and want to begin with a less invasive weight loss procedure. Patients who are ready to start a healthy, new lifestyle that incorporates regular exercise and dietary modifications will benefit greatly from a managed weight loss program. Sustained weight loss is achievable with the assistance of our support team, and we are committed to your long-term weight loss success!
Initial Visit for Your Intragastric Balloon Procedure
Becoming a candidate for an intragastric balloon will be based on several factors:
- Your medical history
- Your weight loss goals
- Previous methods attempted to lose weight
- Your commitment to our team’s managed weight loss program
- Your comfort level with the intragastric balloon procedure
Prior to Your Procedure
You will need to be on Prilosec OTC 40mg (or the generic omeprazole) which should be once daily beginning 2 weeks prior to the procedure. You should stay on this until your balloon is removed.
The Day of Your Intragastric Balloon Procedure
Your procedure will be at JourneyLite of Cincinnati, 10475 Reading Road, Cincinnati OH 45241. If you have any questions for the center, they can be reached at 513-259-2488. Maps/directions can be found at JourneyLite.com. You will need to pre-register prior to your procedure on the site so please do that as soon as possible.
Before your intragastric balloon placement, you should be on a puree/soft solid diet for 48 hours before your procedure date, and should avoid all food and liquid for 12 hours prior, as you will be sedated during the procedure. Typically this will mean nothing to eat or drink after midnight. The puree/soft solid phase is to ensure that there is no solid food left in your stomach that might cause us to have to cancel your procedure.
The deflated balloon will be inserted into your stomach through the mouth, and then filled with a sterile saline. The procedure is generally uncomplicated and lasts 20-30 minutes. You will regain awareness quickly and be monitored until your doctor discharges you (usually a an hour or so). Someone will need to be available to drive you home. You will be given detailed instructions on your aftercare.
After Your Intragastric Balloon Procedure
After the placement of the intragastric balloon, almost ALL patients experience some gastric discomfort, nausea, and vomiting for the first week after the procedure.
This is normal, as your digestive system is adjusting to the presence of the intragastric balloon. You will be given medications to help you manage these symptoms. Please use these medications liberally for the first few days to minimize nausea issues. Please call us if you feel like you are not able to control your symptoms, do not go to the ER unless you feel like there is a life-threatening condition.
Nausea and vomiting is to be expected, especially in the first week after surgery. You will be provided the following medications:
- Zofran (ondansetron):
- dissolve one tablet under tongue every 8 hours for nausea for 7 days
- Levsin (hyoscamine):
- dissolve one to two tablets under tongue every 4 hours as needed for spasm/cramping
There may be other medications prescribed as well. If vomiting persists despite the use of these medications, please contact us for further instructions.
Gastric Balloon Diet
- Days 1-3 – clear liquids
- 100% fruit juice (apple, grape, cranberry)
- Clear broth (chicken, beef, and vegetarian)
- Sugar free popsicles
- Sugar free gelatin
- Water and/or ice chips
- Crystal Light or Sugar Free Kool-Aid
- Decaf Teas and Coffee
- Fast Track Supplements (Dr. Curry’s products–fruit drinks, gelatin, protein bouillon, and hot beverages)
- Avoid the following items days 1-3
- Carbonated beverages
- Sugary drinks (sweet teas)
- Citrus juices (orange, grapefruit, pineapple) and tomato juices
- Juice drinks (Hawaiian punch)
- Days 4-7 – Full liquid/Puree
- Protein Shakes (Premier shakes, Atkins, Low Carb Slim Fast
- Yogurt (carbmaster, Fit and Lite Greek High Protein)
- Milk (skim, 1%, skim milk, almond milk, soy milk) (all unsweetened)
- V-8 juice, tomato juice
- Scrambled eggs
- Sugar free pudding
- Cream Soup (strained) (cream of chicken, cream of mushroom, cream of broccoli)
- Fast Track Supplements (protein shakes and pudding, oatmeal, mash potatoes, scrambled eggs, tomato soup)
- Avoid the following items days 4-7
- Foods with chunks or large pieces
- Sugar desserts (ice cream, regular pudding, cream pies)
- Carbonated beverages
After seven days, you can transition to semi-solid foods. You gradually will transition to solid foods. The length of time for this transition depends on how your body is adjusting to the process. Don’t rush! Be sure your body is comfortable before you move into the next phase of eating.
Some Helpful Tips:
- Plan 3 small meals and 2 small snacks every day.
- Watch your posture during meals and while drinking fluids. Sit tall and do not slouch. This will help with your balloon position properly and increase your tolerance for solids.
- Stop eating when you feel full. One additional bite may be too much!
- Do not drink liquids for 30 minutes before your meal and wait 30 minutes after to drink.
- No solid food starting 3 hours prior to bed time.
- Use your anti-nausea medications as prescribed by the physician.
As soon as you feel well enough (usually about 2 weeks), you may start an exercise program. We recommend getting an activity tracker, such as a FitBit, and aiming for 10,000 steps per day. ReShape patients all receive a free FitBit and wireless scale that feeds data to your ReShape patient portal. If you do this your weight loss will be greatly enhanced!
You will meet regularly with your support team to receive nutritional training and to monitor your progress. Over the next 6 months, this will be an important part of your successful lifestyle change. For patients following the program, our goal weight loss during the first 6 months is 30-50 pounds. Higher-BMI patients will typically be on the high end of this range, and lower-BMI patients on the lower end. Please note that weight loss is not a guarantee with this procedure; there are some patients who do not follow the program and do not lose weight at all.
Removing Your Intragastric Balloon
Removing the intragastric balloon is a similar process to when it was inserted. The main difference is that we need to take some steps to make sure there is no solid food present in your stomach that could lead to aspiration into your lungs at the time of removal. If you do not follow these steps, we may be unable to remove your balloon which means we would have to do another removal procedure after your stomach is emptied.
You need to begin a medication called Reglan 48 hours prior to your balloon removal. Usually this prescription is sent at the time of your balloon placement, if not please contact us with your pharmacy info so that we can arrange this.
You should also refrain from solid foods for 48 hours before the procedure. During this time it is helpful to take frequent sips of Diet Pepsi, Diet Coke or Coke Zero. This is to prevent any food from being present in the stomach on the day of your balloon removal, which could lead to aspiration into your lungs. The carbonation in the diet soda helps to clean the balloon and also move solid food out of the stomach. You should also having nothing at all to eat or drink for 12 hours prior to the procedure as you will be sedated.
First your doctor will remove the sterile saline from the balloon, then remove the deflated balloon. The process should take 20-30 minutes and you will be observed for a time afterward to ensure that you are able to be released. Someone will need to be available to drive you home.
After the Intragastric Balloon is Removed
The 6 months after the intragastric balloon is removed are critical to your successful weight loss outcome. Our support team will work with you every step of the way. We will continue to meet with you on a regular basis, providing support, advice, and answering any questions or concerns that may arise. We are committed to helping you achieve and maintain your weight loss goals, so you can live life to the fullest enjoyment with your new body and improved health!