Background and aim: The intragrastric balloon has been successfully used for the treatment of obesity (BMI>35) or morbid obesity (BMI>40). Gastroesophageal reflux (GER) symptoms are reported sometimes to occur and/or to worsen in treated patients during balloon placement with a variable onset of erosive esophagitis (EE). However previous investigations have not clearly reported the prevalence of EE and if it could be considered as an adverse effect of this procedure.The aim of the present study was to investigate both the prevalence and the severity of esophagitis after the intragastric balloon (BIB, BioEnterics Intragastric Balloon, BioEnterics, Santa Barbara, CA) placement. Material and methods: One hundred twenty one patients (F: 93, M: 28.; mean age 45 yrs(19-65), mean weight 116 kg (73 - 180) mean BMI 41.5 (30 - 63.5) were admitted to the study. Those patients affected by severe esophagitis (grade C-D LA. classification), GU or DU were excluded. The BIB has been placed in the stomach by means of EGD and filled with 500 ml normal saline and methylen blue solution. PPI were administered in the first month to each patient. After 6 month the patients underwent the EGD and the BIB was removed. The presence of EE and related severity by LA classification were recorded Results: Before the BIB insertion only 18 pts (15%) showed mild EE (16 grade A and 2 grade B). After BIB removal EE was observed in 22 pts. (18.2%); 11 pts. with grade A, 7 pts. with grade B, 4 pts. with grade C-D. The prevalence of EE after BIB is statistically significant (Wilcoxon's test P =0.030) Conclusions: Our invenstigation has evidenced that EE prevalence is significantly increased after BIB placement. Therefore we may suggest that EE due to enhanced GER could be considered as an adverse effect of such treatment. Therefore we recommend to maintain the intragastric acid suppression with PPI along the 6 months of BIB placement.
BIB INSERTION INCREASES THE RISK OF EROSIVE ESOPHAGITIS IN OBESE PATIENTS
RICCI, Giorgio;ALVISI, Vittorio
2007
Abstract
Background and aim: The intragrastric balloon has been successfully used for the treatment of obesity (BMI>35) or morbid obesity (BMI>40). Gastroesophageal reflux (GER) symptoms are reported sometimes to occur and/or to worsen in treated patients during balloon placement with a variable onset of erosive esophagitis (EE). However previous investigations have not clearly reported the prevalence of EE and if it could be considered as an adverse effect of this procedure.The aim of the present study was to investigate both the prevalence and the severity of esophagitis after the intragastric balloon (BIB, BioEnterics Intragastric Balloon, BioEnterics, Santa Barbara, CA) placement. Material and methods: One hundred twenty one patients (F: 93, M: 28.; mean age 45 yrs(19-65), mean weight 116 kg (73 - 180) mean BMI 41.5 (30 - 63.5) were admitted to the study. Those patients affected by severe esophagitis (grade C-D LA. classification), GU or DU were excluded. The BIB has been placed in the stomach by means of EGD and filled with 500 ml normal saline and methylen blue solution. PPI were administered in the first month to each patient. After 6 month the patients underwent the EGD and the BIB was removed. The presence of EE and related severity by LA classification were recorded Results: Before the BIB insertion only 18 pts (15%) showed mild EE (16 grade A and 2 grade B). After BIB removal EE was observed in 22 pts. (18.2%); 11 pts. with grade A, 7 pts. with grade B, 4 pts. with grade C-D. The prevalence of EE after BIB is statistically significant (Wilcoxon's test P =0.030) Conclusions: Our invenstigation has evidenced that EE prevalence is significantly increased after BIB placement. Therefore we may suggest that EE due to enhanced GER could be considered as an adverse effect of such treatment. Therefore we recommend to maintain the intragastric acid suppression with PPI along the 6 months of BIB placement.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
