The BIB® System or BioEnterics® Intragastric Balloon System is a conservative, non-surgical, non-pharmaceutical aid in the treatment of obesity and weight reduction. The BIB® System is a soft, expandable, high quality soft silicone balloon that is placed inside the stomach via a camera that enters through the mouth and into the stomach.

Once inserted in the stomach, the empty thin smooth elastic balloon is filled with sterile saline with 500 cc of water (to a diameter of 13cm).

When full, the balloon is too large to pass into the bowel and will now float freely in the stomach.

The Gastric Balloon can help you take control of your weight without the risk of surgery or drugs. Used in harmony with a medically supervised nutrition plan and behavior modification program, it can help you achieve and maintain the health and aesthetic benefits associated with weight loss.

Worldwide, the Gastric Balloon is a clinically accepted tool in reducing excess weight. Clinical trials show that it is more successful than conventional diets, weight loss programs and medications. It has been used in Europe for more than ten years, and globally accepted worldwide.

• The balloon fills a large portion of the stomach, and therefore reduces the capacity of the stomach.
• This creates a feeling of fullness for the patient and does not allow for overeating, therefore allowing the patient to effectively diet without feeling continuously hungry.

• • The procedure is done as an out-patient procedure at Beverly Hills Medical Group. No Hospital stay is required.
  • Our Board Certified Gastroenterologist performs this procedure in conjunction with an anaesthetist and trained nursing staff.
  • The balloon is introduced into the stomach through the mouth without the need for surgery. The physician inserts an endoscopic camera (gastroscope) into the stomach. If no abnormalities are observed, the physician proceeds with the placement of the balloon through the mouth and down the oesophagus into the stomach. Once the balloon is inside the stomach, it is filled with sterile saline through a small filling tube attached to the balloon. Once filled, the doctor removes the tube by gently pulling on the external end, leaving the balloon inside the stomach.

Placement of the balloon takes approximately take 20 minutes, after which you will be monitored by specialist nursing staff in the recovery bay. As this is a “day-only” procedure, you are generally able to be escorted home within two hours after balloon insertion. Although in certain countries like the Philippines, patients are recommended to stay in the hospital for one day for patient care and support.

The BIB® System is designed to assist with weight loss in people who are at least 40% above their ideal weight and who have failed to obtain prolonged weight loss with other weight control programs.

The BIB® System may be particularly useful for people considered too overweight or at increased risk for vital surgery. The use of the BIB® System to successfully reduce weight prior to surgery may help reduce the risks associated with surgical procedures on overweight patients.

The balloon currently can be used for six months. Longer periods of use are not recommended. Over time the acidic content of the stomach will weaken the balloon material and cause the balloon to deflate. Should your physician recommend use of the balloon for longer than six months, it is necessary that the balloon be replaced with a new one when the six-month interval has been met.

While you are using the balloon, your physician may prescribe a course of oral medication to reduce your stomach acid (this may reduce the possibility of stomach irritation and damage to the balloon).

Your physician will place a coloured dye inside the balloon called Methelyene Blue. This will help you clearly identify early deflation or leakage as it will change the colour of your urine.

The balloon is small enough that it may pass through the intestines and leave the body naturally, but there have been some cases in which it has had to be removed from the bowel surgically. If you suspect a deflation, you must notify your physician immediately.

The balloon is removed in the same way it was placed, via the oesophagus and mouth.. Using an endoscopic camera, the physician will introduce a catheter through the mouth and into the stomach. The balloon will then be punctured and deflated. Once the balloon is deflated it can be grasped and removed.

It is important for you to understand that the BIB® System is an aid to weight loss and must be used in conjunction with a diet, exercise and a behaviour modification program. Therefore, the amount of weight you lose will depend on how closely you follow your diet. How long you maintain weight loss will depend on how completely you adopt long-term lifestyle changes involving eating behaviour and exercise.

Weight reduction begins immediately and proceeds as follows (mean data based on several clinical studies):

• Weight loss up to 40 kg
• Mean weight loss 15 kg
• Excess weight loss 40%

BMI decrease 5 kg/m2

Diet Patients who adhered to a diet of 1000-1500 kcal/day lost an average of 18 kg; those who did not managed only 9.6 kg. Thus the balloon helps those who help themselves, since the usual weight loss principles still apply: avoid carbohydrates and fats, and reduce general caloric intake.

It is very likely that the presence of the balloon in the stomach will cause nausea or vomiting for a few days after placement. Your physician will prescribe medication to help minimize these potential effects.

There exists the possibility that you will lose only a small amount of weight or lose no weight at all while using the balloon. Of course, as stated earlier, your commitment to dietary and behavioural changes is a pivotal factor in the outcome.

There is also the chance that unhealthy, uncontrolled weight loss will occur and create adverse health consequences. Be sure to speak with your physician about this.

Every kind of treatment has its own possible problems. Fortunately, they are not in this case life-threatening.

• Balloon intolerance (5-7% of patients). Symptoms are permanent nausea and vomiting, and sometimes pain. If this cannot be adequately relieved, the balloon must be removed.
• Rarely (1%) there can be erosion and ulceration of the stomach, mostly if the patient ignores the instruction to take omeprazole.
• Spontaneous rupture of the balloon (2%). This is manifested in green colouration of the urine. The fact is that we purposely add blue medical dye (methylene blue) to the water during balloon inflation, so that if the integrity of the balloon is compromised the dye is absorbed in the intestine and then discharged with the consequently discoloured urine. Generally it is not dangerous, as the empty balloon usually moves along the intestinal tract and is naturally excreted by bowel movement. Nevertheless, cases have been documented of intestinal obstruction by a ruptured balloon, meaning that in case of balloon leakage the patient must inform his/her doctor urgently. The doctor decides whether to remove the leaking balloon or to await its natural evacuation.
• Insufficient or negligible weight loss. This becomes more probable if the patient fails to follow therapeutic recommendations.
• Feeling of excessive heaviness in the stomach.
• Heartburn.

You can experience significant weight loss averaging between 22-30 kilos; however, your results will depend on how well you follow the program and adjust your eating habits.

There will be discomfort during the first few days. After that, the primary sensation of the Intra Gastric Balloon is a feeling of satiety.

The first three days will be very difficult. Cramping, nausea and vomiting are normal and should be expected. It is very important that you follow your doctor’s instructions. Medication will be given to help ease the discomfort.

You should plan at least three days of inactivity to recover from the procedure. You will be able to resume normal activity sooner or later than this depending on how quickly your body adjusts to the Intra Gastric Balloon.

You can expect to lose more weight with the Intra Gastric Balloon. Because the Intra Gastric Balloon gives you a feeling of satiety, you are better able to control your eating and make healthy changes in your habits.

The follow-up program is critical to success of the balloon and in learning new lifestyle skills. You will meet with your physician and support team at least monthly while the balloon is in place. During this time your progress will be evaluated and you will learn valuable principles of health, nutrition, and exercise that will provide you a foundation for long-term success.

The first week you should not plan any heavy activity. Once your body has adjusted to the Intra Gastric Balloon, you can continue your normal activities. Starting a regular exercise program is highly recommended and will improve your success.

If the Intra Gastric Balloon leaks, you will notice a change in your urine colour (it will be greenish). Although very uncommon, this can be a serious situation. If you notice a change in urine colour, you must call your doctor immediately. If the Intra Gastric Balloon deflates, it will need to be removed by your doctor.

Alcohol in moderation is fine.

You will not feel like eating as much as you used to. In addition, if you eat fatty foods or sweets, you may feel sick. Excessive overeating while the balloon is in place can be dangerous and can result in a serious medical condition.

The Intra Gastric Balloon is removed through the mouth in the same manner it was inserted. The 20-minute procedure is performed under Intravenous sedation or a General Anaesthetic.

The Intra Gastric Balloon is not a magic pill, but a tool to change your lifestyle. Taking part in the program will give you the education and support to change your lifestyle habits and have a better chance for long-term success.