The risk of a gastric balloon rupturing is exceedingly low, especially with modern endoscopic balloons. While older balloon types might have presented such issues, contemporary balloons are designed with enhanced safety features. Should a gastric balloon rupture, its immediate endoscopic removal is crucial to prevent potential complications such as intestinal obstruction.

To further enhance patient safety, modern gastric balloons are typically inflated with a blue-colored saline solution. In the unlikely event of a rupture, the dye will be absorbed and cause the patient's urine to turn blue. This serves as a vital early warning sign, prompting the patient to contact their physician promptly. This allows for timely intervention before the balloon can exit the stomach.

Although rare, if the blue urine is not noticed and the balloon passes into the small intestine, it could potentially lead to symptoms of small bowel obstruction. In some instances, the balloon may even pass naturally through the bowel and be expelled. Nevertheless, the overall incidence of such complications is remarkably low with current balloon technologies.