Despite the efforts made to prevent obesity in the world, the decrease in its prevalence is not at the expected level. In obese patients, 3-9% weight loss can be achieved in a 1-year period with non-surgical treatments (diet changes, medical treatments and exercise applications). The search for an easily applicable, effective and safe treatment with a low complication rate in the treatment of obesity continues. For this reason, Botulinum Toxin-Botox application into the stomach has started to be performed since 1993 in patients who are not suitable for surgical intervention and cannot lose sufficient weight with diet and exercise.
What is Botox?
The medical treatment form of Botulinum toxin type A neurotoxins produced by the bacterium Clostridium botulinum is called Botox. Botulinum toxin type A blocks the release of acetylcholine at the neuromuscular junction, causing the neural transmission between the central nervous system and the peripheral nervous system to be interrupted. Botulinum toxin type A provides its gastric emptying-reducing effect with its neurotoxin-associated protein (NAPs) content.
It is used to reduce contraction in smooth and striated muscles in different diseases (such as ocular strabismus, common esophageal spasm, achalasia, oropharyngeal dysphagia, anismus, anal fissure and anterior rectocele) and in medical aesthetic fields.
What is the Purpose of Use in the Stomach?
With the developing field of endoscopic treatment, less invasive interventions are being performed today and different options are emerging in the treatment of obesity. It has been shown in experimental and clinical studies that injection of Botox into the stomach wall causes a decrease in appetite and food intake, a prolongation of gastric emptying time, early satiety and an increase in weight loss. Botox hypothetically delays gastric emptying by inhibiting the release of acetylcholine at the neuromuscular junction and inhibits the secretion of ghrelin, a powerful hormone released from the gastric fundus that stimulates hunger. Experimental evidence shows that botox directly inhibits tachykinin substance P (SP)-induced pyloric smooth muscle contractility in a concentration- and time-dependent manner.
To whom is Gastric Botox performed?
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Botox application diet and ecze It is applied to mild and moderately obese patients who cannot lose enough weight despite weight loss, who are over the age of 18, and who do not have a stomach disease that prevents the procedure during endoscopic evaluation. There is not enough information for its use in pregnant and breastfeeding patients.
How is Stomach Botox applied?
In the endoscopy unit, botox injection is applied into the stomach from different points under superficial sedation. There is no need for detailed preparation before the procedure. Studies have shown that large areas and multiple injections (>10), including the fundus or corpus rather than just the antrum, have a positive relationship with weight loss. The rate of significant side effects and complications in Botox application is extremely low and it is considered a very safe procedure. After the procedure, the patient returns to his/her daily life immediately.
What is the Duration of Effect of Stomach Botox?
Botox The duration of effectiveness after injection varies between 3-6 months. Botox injection is limited only to the stomach and does not spread or affect other organs. Weight loss rates during this period in patients receiving Botox may vary depending on personal factors such as age, metabolic rate, additional diseases and lifestyle. The process should be supported with diet and exercise. Low-calorie foods should definitely be preferred during this process. If necessary, the procedure can be repeated after six months in patients who have lost sufficient weight.
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