Tuesday, March 1, 2016
So lets talk about Reflux Management
By: John G. Touliatos, MD with Advanced Surgeons, P.C.
There is a medical device for patients 21 years and older who have been diagnosed with GERD called LINX. When patients continue to have heartburn or regurgitation despite taking medication to treat GERD, LINX can be used.
What exactly is GERD? It occurs when the sphincter (valve) between the stomach and the esophagus is weak or opens improperly and allows stomach acid (juices) to reflux into the esophagus and may cause injury to the esophagus and result in heartburn or regurgitation
The LINX system is designed to help the sphincter stay closed to stop the reflux. It uses a small, flexible band of beads. Each bead has a magnet inside. When placed around the outside of the esophagus, the magnet attraction between the beads helps the sphincter stay closed to prevent reflux. Swallowing food will overcome the magnetic attraction and allow the beds to separate, allowing food and liquid to pass normally into the stomach.
Why doctors choose to use this method? This is another option to surgery for GERD, for those whom the Nissen fundoplication seems too invasive. The LINX system does not involve significant alterations to the anatomy that may limit future treatment options. With the Nissen fundoplication, the top part of the stomach is wrapped around the lower esophagus to improve the reflux barrier.
If needed, the LINX system can be removed laparoscopically similar to the way the implant procedure is performed (<1%). Removal of the device generally leaves the esophagus the same as before the implant. After surgery, patients usually go home the same day or the next day. Patients are able to eat a normal soft diet after surgery, and it is well-tolerated by patients. If you have the Nissen fundoplication, patients are restricted to a liquid diet for 3- 4 days that is slowly advanced over weeks to normal food.
Contraindications for the provider are patients who are allergic to titanium, stainless steel, nickel, or ferrous materials. Another consideration is people who need or expect to need an MRI. The newer devices are safe, but it is still may affect the durability or effectiveness of the device. There is no risk of injury to the patient if the MRI is done. It is recommended that anyone implanted with the LINX system register the device with the MedicAlert Foundation.