Follow up
After IGB insertion and before discharge, patients remained for almost 1-2h in the anesthesia recovery room until full recovery from sedation. Instructions were provided for a 5-day liquid diet (with progressive increase in the ingested volume). On the sixth day, a semi-solid diet was prescribed and, after the thirteenth day, solids were introduced into a 1200 kcal/day diet. Afterwards (maximum 15 days after IGB placement), the patients were referred to a personalized nutritional counseling, when an individual diet was prescribed with a range of 10-15 kcal/kg/day. Monthly follow up with a multidisciplinary team (dietitian, psychologist and doctor) was offered to all patients.
In the first three days after balloon insertion, patients were instructed to use three anti emetic drugs (metoclopramide, ondansetron and dimenhydrinate), an anti-foaming drug (dimethicone), and analgesics/antispasmodics (escopolamine plus dipyrone and acetaminophen). All patients were instructed to use proton pump inhibitor (PPI; pantoprazole magnesium) throughout the treatment: a double dose in the first month (80mg) and a full dose from the second month (40mg) to the end of the treatment. Additionally, vitamin and mineral supplementation and probiotics (Lactobacillus acidophilusLA 16) were given to all patients during the entire treatment.