Gastric balloon: how it is placed and removed, side effects and risks

The balloon takes up space in the stomach so that you feel full on smaller meals. It is used as a temporary tool to help people change how they eat, particularly when they want something less invasive than an operation. The NHS lists the gastric balloon among the four main types of weight loss procedure, alongside bypass, band and sleeve.

It does not suit everyone, and the team will check your history before agreeing. Your team will explain why they do or do not recommend one for you.

A balloon is not a permanent solution. The Hull leaflet notes the balloon must be removed within a set time, and weight that has been lost can return if the new eating habits do not continue afterwards. The same leaflet mentions that around 1 in 5 patients may not see a significant reduction in weight.

Alternatives include structured diet and activity programmes, weight-management medicines where they are appropriate, and surgical operations such as sleeve gastrectomy or bypass. The NHS says non-surgical options such as healthy diet, exercise and medicine are expected to have been tried before weight loss surgery.

The balloon differs from surgery in that nothing is cut or permanently changed, so it can be reversed by removing it. Against that, it is temporary by design, and the benefits depend on the support and diet changes that go with it.

You will be asked about your medicines and allergies, and given fasting instructions because the procedure uses an endoscope and sometimes sedation. The Hull leaflet says you may have a local anaesthetic throat spray or light sedation through a vein, and that someone must collect you and stay with you for 24 hours.

You will also be told about the acid-suppressing and anti-sickness medicines you will need afterwards, so it helps to have these ready.

• Arrange a lift home and a responsible adult for 24 hours afterwards.

• Tell the team about reflux, previous operations and all medicines.

• Plan a few quiet days at home, because early nausea is common.

The doctor first passes a flexible camera through the mouth into the stomach to check for anything that would make the balloon unsafe. The deflated balloon is then swallowed with the tube attached, and, guided by the camera, filled with sterile saline and blue dye. The Hull leaflet gives 15 to 20 minutes for the procedure and says no overnight stay is required. The NHS gives around 20 minutes and describes local anaesthetic or sedation being offered.

The blue dye is there as a safety signal. If the balloon were to leak, the urine would turn green, and the leaflet lists this as a reason to seek immediate medical attention. Balloon designs differ between services, so ask which type you are being offered and how long it can stay.

Removal is a second endoscopy. The Hull leaflet describes puncturing the balloon, draining it and pulling it out, also in about 15 to 20 minutes and without an overnight stay.

The first days are the hardest. The Hull leaflet lists sore throat, reflux, abdominal pain and cramps, nausea and bad breath as common, and says vomiting and nausea affect 95% of people. You are given acid-suppressing medicine, such as lansoprazole or omeprazole, daily, plus anti-sickness medicine, typically for about a week, and anti-spasm tablets as needed, according to the leaflet.

Serious risks are rare. The leaflet quotes balloon rupture below 1 in 200, bowel obstruction or perforation below 1 in 200, bleeding below 1 in 10,000, and mentions aspiration pneumonia and a very rare risk of death. Obstruction can occur if a deflated balloon passes into the bowel, which is why prompt action on warning signs matters.

Ask your team how often balloons in their service are removed early because of intolerance, which the retrieved leaflet does not quantify.

Most people feel unwell for a few days and eat very little at first. The Hull leaflet says small meals are required and that high-calorie, fatty and sugary foods should be avoided, with more detailed diet advice in a separate leaflet. Eating slowly and stopping when full are central.

Do not skip the acid medicine, because the balloon can aggravate reflux. Keep every follow-up appointment with the dietitian, and ask what support continues after removal, since this is when many people find it hardest to keep weight steady.

The Hull leaflet lists two situations for immediate medical attention: urine turning green, which can mean the balloon has ruptured, and severe abdominal pain, vomiting or progressive bloating, which can mean obstruction or perforation.

Treat these as urgent: contact the unit or go to A&E, and call 999 if you are severely unwell or in intense pain. Tell the staff you have a balloon in your stomach.

• Which type of balloon is being used and for how long can it stay?

• What support and monitoring is included while it is in place and afterwards?

• What medicines will I take and for how long?

• What happens if I cannot tolerate the balloon?

Balloon availability on the NHS depends on local commissioning and is not offered everywhere, whereas private services commonly offer it as a programme. Ask exactly what is included, such as dietitian visits, removal, and treatment of complications, because the balloon on its own is only part of what makes it work.