ENA gastric balloon in Germany is what people look at when they do not want a stomach operation: nothing is cut or stapled. A soft balloon is placed through the mouth during a gastroscopy and taken out the same way.
This page covers who the balloon is for, how placement and the first days go, the programme around it and what happens after removal. First, though: the balloon is a temporary measure, not a cure for obesity. Obesity itself is covered under obesity treatment in Germany.
What a balloon does in the stomach
The balloon takes up space, so a smaller meal is enough to feel full, and the stomach empties more slowly. Absorption is not affected, unlike the operations that reroute the bowel.
It is usually considered for people whose weight is above the healthy range but below the threshold for bariatric surgery, and for those who need to lose weight before another operation, such as a joint replacement, to lower the anaesthetic risk.
It is ruled out by untreated reflux with a large hiatal hernia, a previous stomach operation, ulcers, pregnancy and certain medicines, such as aspirin, anti-inflammatory painkillers or blood thinners. This list is checked by the doctor, not assumed from the internet.
The kinds of balloon and how long they stay
The common type is a soft balloon filled with liquid, a saline solution, during an endoscopy. Sometimes a dye, methylene blue, is added: if the balloon leaks, the urine turns blue-green.
The other variant is a capsule swallowed on a thin tube: once an X-ray shows it in the stomach, it is filled through the tube, without sedation. Adjustment differs too: its term is fixed by design, as a valve opens at the end and the empty balloon passes naturally, whereas an endoscopic balloon comes out when the doctor decides and some models allow the volume to be changed.
A balloon is always temporary and is removed after an agreed period. The clinic states the exact term and the product in its written plan; the costs are explained on the gastric balloon cost page.
Placement, removal and the first days
The appointment starts with a gastroscopy to look at the stomach, then the balloon is placed and filled under sedation, a light medically induced sleep. After a short observation the patient goes home the same day or the next. Removal is also done by gastroscopy.
The first days usually bring nausea, cramping and vomiting while the stomach gets used to the balloon. Medication is prescribed for exactly this, and patients are told before they agree, not after.
With vomiting that will not stop, severe pain or any sign that the balloon has lost its filling, such as blue-green urine or sudden hunger, the clinic has to be called rather than waited out: a deflated balloon can slip into the bowel. Surgical care in general is described under surgery in Germany.
What the balloon does not do
The balloon buys a window of time in which habits can change. When it comes out, appetite returns, and without the change the weight comes back. Reviews of the studies describe regain after removal as common, not exceptional.
It is not a substitute for a sleeve or a bypass, nor a small version of them; in higher weight ranges, surgery is what is discussed. See bariatric surgery in Germany and gastric bypass in Germany.
Before agreeing to any of these, doctors in Germany look at the weight history, accompanying illnesses, previous attempts, and what is being done about eating and movement in parallel. For operations, this is set out in the German specialist-society guideline on the surgical treatment of obesity (link to a published summary).
The programme around the balloon
A balloon on its own is not treatment: nutrition counselling, an eating plan, movement and regular check-ups belong to it, and serious clinics only place it as part of such a programme.
For a patient living abroad, that means settling before the trip who provides the counselling at home, in which language the plan is issued, and who removes the balloon if the patient is not in Germany at the end.
Frequently asked questions
Is the balloon placed under general anaesthesia?
Usually not. An endoscopic balloon is placed under sedation, a light medically induced sleep, and the swallowable capsule needs no sedation at all. The doctor chooses the kind of sedation or anaesthesia for each patient, taking into account heart and lung disease and how sedation was tolerated before.
What complications can a balloon cause?
Serious complications are rare but exist: stomach ulcers, a deflated balloon slipping into the bowel and blocking it, inflammation of the pancreas and perforation of the stomach wall. So patients learn before the placement which signs mean calling the clinic at once: vomiting that will not stop, severe pain and any sign of deflation.
Which medicines should be avoided with a balloon?
Medicines that irritate the stomach lining are taken only with a doctor’s approval: aspirin, anti-inflammatory painkillers such as ibuprofen, and blood thinners. If one cannot be stopped, this is discussed beforehand. A medicine that lowers stomach acid, however, is usually taken for as long as the balloon is in place, to protect the lining from ulcers.
Can the balloon be taken out early?
Yes. If nausea and vomiting do not settle despite medication, if the balloon has deflated or a complication appears, it is removed early. In studies, some patients stopped early because of side effects. Who would do this, and where, is best settled before the placement, especially if the patient flies home soon after.
How AlenMed arranges a gastric balloon in Germany
An enquiry starts with medical information: height and weight history, current illnesses, medicines, previous stomach operations and any gastroscopy reports go to a gastroenterologist, who says whether a balloon is appropriate at all. Only then does the clinic issue a written estimate, followed by the visa invitation letter, dates and an interpreter. One gastroenterologist the company works with is Dr Martin Fuchs, chief physician of the Department of Gastroenterology, Hepatology and Gastroenterological Oncology at Munich Hospital Bogenhausen.
Worth asking in advance: which product is used, whether removal is included, who is in charge between placement and removal, and what happens if the balloon has to come out early.
This material is for information only and is not an offer. The indication and the method are decided by a doctor in person.