Endoscopic volume adjustment of intragastric balloons for intolerance

Background: A new type of saline-filled, spherical-shaped balloon, which moves freely within the stomach, has been increasingly used as a tool to assist weight reduction. Balloon intolerance is an infrequent complication, characterized by continuous nausea and vomiting or abdominal pain, uncontrollable by medical therapy. This has usually been followed by puncture, deflation and extraction of the balloon. Methods and Results: We present 4 patients in whom intolerance was treated by endoscopic volume adjustment of the device. After partial defilling of the balloon, epigastric symptoms disappeared rapidly, while the patients respectively lost 5.2, 14.4, 5.9 and 15.8 kg of body weight at the end of the treatment. Practical recommendations are provided to ensure a successful endoscopic reintubation of the balloon's valve. Conclusion: Early intolerance to an intragastric balloon can be successfully treated by endoscopic volume adjustment of the device.