title: Incomplete stomach emptying as a complication of intragastric balloon treatment and a solution suggestion: Pineapple juice drinking.
abstract: OBJECTIVE
  During removal of intragastric balloon, there is a great deal of gastric undigested food even after an eight-hour starvation. Bromelain, a proteolytic enzyme existing in the pineapple juice seems to be a good choice for the undigested food remnants in the stomach. We aimed to investigate the effect of drinking pineapple juice on dissolving food remnants in patients undergoing endoscopic procedure for removal of intragastric balloon.
  
  
  METHODS
  In this study, we included patients who had undergone endoscopic placement of intragastric balloon (BIB®, BioEnterics Intragastric Balloon, Inamed Health, CA, USA) between February 2009 and March 2012. First 8 patients were asked to fast the whole night before the procedure (at least 8 hours) and to apply clear liquid diet for 3 days before the endoscopic removal. A great amount of food remnants was seen in the stomach during the endoscopic balloon removal procedure. A second endoscopic procedure was planned 3 days later and, in order to decrease the food remnants, the patients were asked to drink 1 L pineapple juice per day. The next 11 patients were also advised to drink 1 liter per day of 100% pineapple juice for 3 days before the endoscopic removal.
  
  
  RESULTS
  Totally, 19 obese patients (17 female, 2 male) were included in the study. Mean age was 38,68±7,95 years, mean weigh was 124,23±19,30 kg, and mean body mass index was 49,73±9,22 kg/m 2 . There was undigested food in the stomach during endoscopic removal in the first 8 patients. However, no undigested food in the stomach was found at the second endoscopic examination. In the other 11 patients, no food remnants were observed after taking pineapple juice prior to the endoscopic removal procedure.
  
  
  CONCLUSIONS
  Drinking pineapple juice for 3 days before endoscopic balloon removal seems to be effective in dissolving food remnants in the stomach. Drinking pineapple juice may be recommended in all patients undergoing endoscopic procedure for removal of intragastric balloon.
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Research Hospital, Department of Gastroenterology, Ankara, Turkey.
authors.forename: Zahide
authors.initials: Z
authors.lastname: Simşek
authors.forename: Akif
authors.initials: A
authors.lastname: Altınbaş
authors.forename: Tuncay
authors.initials: T
authors.lastname: Delibaşı
authors.forename: Osman
authors.initials: O
authors.lastname: Yüksel
mesh_terms: D000328:Adult; D031230:Ananas / Q000201:enzymology*; D001628:Beverages; D001963:Bromelains / Q000008:administration & dosage; D020878:Device Removal / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D015905:Gastric Balloon / Q000009:adverse effects*; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy; D015431:Weight Loss
chemical_list: D001963:Bromelains