The Effect of the Intra-gastric Balloon on Gastric Emptying and the DeMeester Score

Sergio Barrichello, Dilhana Badurdeen, Abdellah Hedjoudje, Manoel Galvão Neto, Robin Yance, Andre Veinert, Lea Fayad, Cem Simsek, Eduardo Grecco, Thiago Ferreira de Souza, Cynthia Teixeira, Gabriel Cairo Nunes, Anthony N. Kalloo, Mouen A. Khashab, Vivek Kumbhari

Research output: Contribution to journalArticlepeer-review


Background and Aims: The mechanism of weight loss with the intra-gastric balloon (IGB) is thought to be a decrease in gastric emptying (GE); however the evidence is conflicting. Nausea, abdominal pain, and gastroesophageal reflux disease (GERD) can cause intolerance resulting in early removal. This is demoralizing for the patient and costly for the healthcare system. The ability to predict which patients will have superior weight loss and tolerance is invaluable. We sought to investigate if the IGB induced weight loss by reducing GE and the effect of the IGB on the DeMeester score. Methods: We retrospectively reviewed prospectively collected data for patients undergoing IGB placement at a single hospital. Manometry and pH studies were performed before and with the IGB in place. Weight was measured at baseline, at removal, and 6 months later. Adverse events leading to early removal were recorded. Results: Twenty-four patients were evaluated. There was a statistically significant decrease in GE for solids with the IGB (117.92 ± 150.23 vs 281.48 ± 206.49 min; p = 0.0048), but not for liquids (54.44 ± 17.97 vs 56.08 ± 43.96 min; p = 0.7228). The lower esophageal sphincter (LES) pressure did not change significantly with placement of the IGB (17.76 ± 7.39 vs 14.74 ± 7.24 mmHg; p = 0.09). On multivariate analysis, increase in DeMeester score was associated with total body weight loss (p = 0.0125) and change in GE (p = 0.038) independently. Conclusion: The IGB delays GE for solids, but not for liquids, and increases the DeMeester score by a mechanism other than a loss of LES pressure.

Original languageEnglish (US)
Pages (from-to)38-45
Number of pages8
JournalObesity Surgery
Issue number1
StatePublished - Jan 1 2020


  • DeMeester score
  • Endoscopic bariatric therapy
  • Gastric emptying
  • Intra-gastric balloon

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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