AGA’s new clinical guidelines recommend the use of IGB for obese patients

Obesity is a worldwide pandemic, affecting about 40% of adults within the United States. There is a gigantic unmet want for an efficient weight-loss answer. After an in depth evaluation of obtainable literature, the American Gastroenterological Association (AGA) has launched new medical tips recommending using intragastric balloons (IGB) for sufferers with weight problems who haven’t been in a position to shed extra pounds with conventional weight-loss methods.

This therapy is most profitable with accompanying remedy, akin to way of life modifications and pharmacological brokers, and can be utilized in a sequential method or together with bariatric surgical procedure. These tips are revealed in Gastroenterology, AGA’s official journal.

Endoscopic bariatric therapies have advanced as a lovely instrument for weight reduction, nonetheless, lower than 5% of sufferers with weight problems looking for a weight reduction remedy are conscious of endoscopic weight reduction choices. Our hope is that this new guideline can result in shared determination making between sufferers and suppliers to find out if intragastric balloons are the most effective weight reduction choice for that particular person affected person.”

Thiruvengadam Muniraj, MD, MRCP, Study Lead Author, School of Medicine, Yale University

With the exception of acknowledgement that fluid-filled balloons could also be related to greater efficacy however decrease tolerability than air-filled balloons, the rule of thumb makes no suggestions on particular units.

Key guideline suggestions:

1.Patients with weight problems looking for a weight reduction intervention ought to think about using intragastric balloon remedy to reinforce the impact of average to excessive depth way of life modifications.
2.To decrease gastrointestinal bleeding threat, deal with sufferers present process IGB remedy with proton pump inhibitors (PPIs).
3.To keep away from nausea, sedate sufferers for the IGB placement with anesthetics related to low incidence of nausea, and proceed anti-nausea remedy for 2 weeks.
4.While screening for dietary deficiencies is not wanted, offering 1-2 multivitamins after IGB placement is usually recommended.
5.To maintain weight off after IGB removing, AGA recommends dietary interventions, pharmacotherapy, repeat IGB or bariatric surgical procedure. The selection of this upkeep technique needs to be decided primarily based on a shared decision-making strategy.

“Shared determination making is a crucial element of weight problems remedy – for the whole lot from choosing the proper IGB system to what concomitant way of life modifications, pharmacotherapy or sequential procedures a affected person ought to pursue. This shared determination making ought to think about the affected person’s values and preferences, stability advantages and harms throughout the affected person’s medical and behavioral context, and think about price and availability,” added Dr. Muniraj.