Imagine getting rid of your acid reflux, protecting your health, and improving your quality of life. That’s the premise behind LINX® Reflux Management System is a laparoscopic procedure that eliminates the symptoms caused by gastroesophageal reflux disease (GERD). In February 2019, general surgeons Peter Dahlberg, M.D. of Western Wisconsin Health and Ranjit Singh, M.D. of Hudson Physicians began performing the LINX® procedure at Western Wisconsin Health.
The lower esophageal sphincter acts as a barrier to the reflux of acid from the stomach into the esophagus. By opening, it allows food and liquid to enter your stomach when you swallow. The sphincter should close after the food has passed, but this process is flawed in patients with GERD, causing heartburn, chest pain, regurgitation, and other problems. Over time, damage from stomach acid can even lead to changes in the esophageal lining that are associated with a higher-than-average risk for developing esophageal cancer.
Medications used to manage GERD decrease stomach acid production and usually eliminate symptoms of heartburn. However, they do not stop reflux from occurring, and long-term use can occasionally lead to serious health problems.
“Often when I meet patients for the first time, they don’t know that there are other options beyond medication,” says Dr. Dahlberg.
According to Dr. Singh, the first steps toward relief are simple. “We try all the conservative measures first – diet, lifestyle modifications, and medication. If reflux symptoms persist, patients are screened with an endoscopy to gauge the severity of the reflux, the presence of a hiatal hernia, and any other associated stomach or esophageal conditions. Patients who are considering surgical treatments undergo pH testing and manometry to determine if they are a candidate for LINX® surgery.”
How LINX® Works
The LINX® procedure uses a flexible ring about the size of a quarter. Made of magnetic beads, this ring is surgically implanted around the esophagus after any hiatal hernia that is present is repaired. Once it’s placed, the device strengthens the lower esophageal sphincter and prevents reflux. The surgery does not alter the stomach anatomy to the extent that other anti-reflux procedures, such as the Nissen fundoplication, do.
Most patients go home after surgery or after one night in the hospital and they resume their normal routine and diet within a few days. In fact, many enjoy foods they previously couldn’t tolerate with GERD. The device is designed to last a lifetime, but if it does not operate properly or is not tolerated by the patient, it can be removed.
Outcomes and Considerations
“There will always be a place for Nissen fundoplication, but LINX® is becoming more popular because it’s a more elegant way to treat the reflux problem,” Dr. Singh explains.
The LINX® device has demonstrated good clinical outcomes since being approved by the FDA in 2012. In most studies, 85 percent of patients no longer depended on daily medication after surgery, and 90 percent are free from regurgitation and heartburn a full five years after surgery.
“The main side effect with LINX® is dysphasia (difficulty swallowing), but within three months of surgery, there’s less than one percent chance of that,” says Dr. Dahlberg.
Another concern that some patients have about LINX® is MRI compatibility. The device is compatible with the newer MRIs found in 94 percent of hospitals in America, and although every patient is given an implant card to carry in their wallet, going through airport security does not present problems.
Are You a Candidate?
If you have chronic heartburn or other reflux symptoms that do not respond to lifestyle changes or medications or you want to avoid the risk of taking PPIs, LINX® may be a good treatment option.
With reflux problems resolved, patients are surprised how much more enjoyable life can be. “Some of my happiest patients are those who no longer have to worry about reflux or regurgitation and can once again savor their meals,” says Dr. Dahlberg.