Flanged gastrointestinal devices and methods of use thereof

A gastrointestinal device comprising:

• (a) a sleeve configured to carry fluid from its proximal end to its distal end, wherein its proximal end is configured to be at or proximal to a subject's pyloric orifice and its distal end is configured to be at or distal to the subject's duodenum;
• (b) an anchor connected to the sleeve, the anchor configured to be retained within a duodenal bulb;
• and
• (c) a flange positioned proximal to the anchor, the flange configured to resist distal migration of the gastrointestinal device,
• wherein a coupling liner connects the anchor to the sleeve at a sleeve-coupling interface, wherein a relaxed diameter of the anchor is greater than a maximum diameter of the sleeve at the sleeve-coupling interface;
• or
• wherein the anchor is configured to exert an outward radial force on the sleeve at the sleeve-coupling interface, wherein the outward radial force on the sleeve at the sleeve-coupling interface is configured to maintain the sleeve in an open configuration at the sleeve-coupling interface, wherein the sleeve-coupling interface is at or distal to the distal-most end of the anchor or wherein the sleeve-coupling interface is from 1-6 inches distal to the flange.