Risks and Complications Gastric Balloons
Like all medical and surgical procedures, having an gastric balloon can carry risks and can result in unpredictable complications. The relative risks and potential benefits need to be assessed on an individual basis and depend on factors such as your medical history and personal circumstances. This will be discussed with you by your doctor in detail prior to committing to any procedure.
Some of the potential risks associated with gastric balloon therapy are outlined below.
Endoscopy Related Risks
Anaesthesia
The anaesthesia required for the insertion, adjustment or removal of a gastric balloon can have risks of complications, injury and in rare cases, death.
Aspiration
Regurgitation of stomach fluids or food into the lungs can occur during balloon implantation, adjustment or removal. This is unlikely, particularly if the pre-procedure diet is followed as instructed. If food is found in the stomach during a procedure, it will be aborted due to the risk of aspiration. Severe aspiration is extremely rare, and preventative measures are in place. However, in rare cases, it can lead to pneumonia, respiratory failure requiring ventilatory support, or even fatal complications.
Bleeding
Significant bleeding after an endoscopic procedure is uncommon. Bleeding may occur during endoscopy or immediately afterwards. A blood transfusion may be required in these rare circumstances and perhaps a repeat endoscopy or surgery is needed to stop bleeding.
Injury
Injury to the stomach or oesophagus is a rare complication that can cause life-threatening complications. In the rare instance that this does occur, admission to hospital, surgery, periods of fasting and/or treatment with antibiotics may be required’
Organ Failure
In very rare circumstances, organ failure may occur following gastric balloon placement or adjustment. This may include failure of the kidney, heart, lungs or liver.
Admission to Hospital
In the unlikely event of a complication from the procedure or anaesthesia, a hospital admission may be required. In some cases, surgery may be necessary to treat a problem or complication caused from the gastric balloon or procedure.
Deep Vein Thrombosis (DVT)/Pulmonary Embolism
Blood clots after endoscopic procedures are uncommon. Blood clots can form in the legs, or elsewhere, and break off and travel to the heart and lungs causing injury or death.
Other Complications that may be common
Allergic reactions, headaches, itching, medication side-effects, damage or irritation of the vein where intravenous medications were given, heartburn/reflux, anaesthetic complications, injury to the bowel or vessels, gas and bloating
Death
The mortality rate following complications of the gastric balloon procedure is low, estimated at less than 1 in 10,000.
Gastric Balloon Related Risks
Post-Procedure Symptoms
These are common in the first few days after balloon placement. Patients may experience stomach cramps, stomach pain or discomfort, nausea, acid reflux with heartburn or indigestion, minor bleeding in the oesophagus, and a feeling of fullness or bloating. To minimise these symptoms, medications are prescribed to control them and should be taken as directed by the doctors and nurses at The BMI Clinic. Less common symptoms that patients may experience include diarrhoea, vomiting, sore throat, excessive salivation, gas or belching, hiccups, gastrointestinal hypermotility, oesophageal dysmotility, aspiration, hyperventilation, gastritis, halitosis (bad breath), indigestion, or dizziness.
**If any of these symptoms persist or worsen, you should contact The BMI Clinic immediately.
Ulcers
Patients may develop an ulcer in the stomach, oesophagus, duodenum, or intestine due to the gastric balloon. To reduce this risk, a proton pump inhibitor (PPI) is often recommended as a preventative measure. If an ulcer develops, treatment may include medication and endoscopic procedures while the balloon is in place. In some cases, additional endoscopic procedures (under anaesthesia) may be required for monitoring or treatment, and early removal of the gastric balloon may be necessary.
Dehydration
Dehydration may occur after balloon placement and some patients may need to have additional intravenous fluids administered.
Pancreatitis
The gastric balloon may cause inflammation of the pancreas. Mild cases of pancreatitis may resolve with or without treatment, but severe cases can cause life-threatening complications. Pancreatitis may require early removal of the gastric balloon.
Balloon Intolerance
Approximately 5% of patients do not tolerate the gastric balloon. These patients will experience prolonged nausea, reflux and/or abdominal pain requiring early removal.
Balloon Deflation
Although uncommon, the balloon may deflate at any point after insertion. The deflated balloon will generally pass through the intestines and be expelled with the stool. In rare cases, it can cause an obstruction in the stomach or in the intestines, requiring surgery for removal. The saline used to inflate the balloon is stained with a blue dye, called methylene blue. Should the balloon deflate, you will likely notice that the dye turns your urine blue-green in colour. You may also notice a change in your appetite, or the ability to eat larger amounts of food. If you suspect the balloon has deflated, you should contact the clinic immediately (including by the 24-hour patient support number on 1300 376 026). You will be booked to have the balloon removed endoscopically within 24-48 hours.
Gastrointestinal Injury
The balloon may rub against the stomach causing bleeding, a tear (perforation) or hole. Gastric perforation is a serious complication that occurs in about 1-in-2500 patients. Endoscopy and/or surgery, with removal of the balloon, and repair of the area of bleeding or injury is likely to be required for treatment. Patients with a history of prior gastrointestinal or bariatric surgery are not eligible due to the increased risks of gastrointestinal injury
Balloon Removal
The gastric balloon must be removed after the indicated time-period specified by the balloon manufacturer and by the physician/surgeon. This will require an additional endoscopic procedure for its removal. Complications related to exceeding this period can be serious and life-threatening.
Psychiatric Complications
Although most people experience improvements in their mood with weight loss, some may experience worsening states of depression, which can lead to suicide. Some patients also experience anxiety from the foreign body within their stomach. Patients taking psychiatric medications must disclose this treatment to their physician/surgeon and should have the dosage and effectiveness of these medications monitored carefully by their prescribing physician.