Acid reflux surgery: why choose LINX?

In this article Mr Nick Boyle – one of the most experienced surgeons in Europe to offer the LINX procedure – talks about the instances where LINX might help you, the benefits of LINX over other treatments and what you can expect from LINX.

What symptoms can LINX help to address?

Reflux can cause all sorts of symptoms. Some are easily associated with reflux such as heartburn. Others may be less obviously reflux related, such as a cough, voice problems or chest pain. Symptoms can include (but are not limited to):

• Heartburn
• Regurgitation 
• Recurrent Cough
• Difficulty swallowing
• Chest pain
• Sensation of a lump in the throat
• Throat clearing
• Husky or weak voice
• Bad taste
• Sensation of shortness of breath

What is LINX and how can it help prevent acid reflux?

LINX is a minimally invasive, cutting-edge surgical procedure. 

During LINX surgery, a bracelet of magnetic beads is placed around the bottom of the oesophagus. The LINX implant helps to strengthen the lower oesophageal sphincter – the valve that is responsible for preventing reflux. 

LINX augments the strength of this valve, so the normal barrier between the stomach and oesophagus is re-established. This helps to prevent acid reflux.

What tests are needed prior to deciding on LINX surgery?

You will be offered tests dependent upon a specific assessment of your symptoms.

Firstly, other conditions that can cause reflux symptoms must be excluded. These can, at worst, include malignancy (meaning the presence of a malignant tumour – in other words, a cancer diagnosis). 

However, you could have a condition that affects the stomach and oesophagus that may be more benign. This could cause similar symptoms to reflux, while being a different condition. These similar conditions need to be ruled out.

Breath tests

Sometimes we will recommend breath tests to see if there are any problems with how your stomach is emptying or diagnose a different condition such as small intestinal bacterial overgrowth (SIBO), in which abnormal micro-organisms in the gut can cause similar symptoms to reflux. 

Endoscopy

Most people will need to have an endoscopy. This assesses the anatomy of your oesophagus and stomach, and lets us look for signs of problems caused by reflux, such as Barrett’s oesophagus, inflammation or narrowing. 

BRAVO pH and impedence tests

A diagnosis of reflux can also be confirmed through a BRAVO pH test, which is inserted at the time of an endoscopy. Alternatively, we may suggest an impedance test. This is performed by inserting a small catheter into the oesophagus via the nose for 24 hours, and holds an advantage over the BRAVO pH test as it can measure both acidic and non-acidic reflux. 

Manometry

We will usually also want to perform manometry, which assesses how the muscles and nerves in the oesophagus that control swallowing are working. 

Based on your diagnosis, we’ll decide if LINX is the best option for you.

5 benefits of LINX over other treatments

• LINX is minimally invasive
  It is performed during a keyhole procedure, using 4 tiny incisions. Most people return home on the same day and recover quickly. The procedure involves minimal disruption to your body.
• It is low risk
  There have been over 40,000 procedures safely performed worldwide.
• There are fewer side effects
  The side effects that can occur after traditional fundoplication operations, such as difficulty belching or vomiting, tend not to occur following the LINX procedure.
• It is highly effective
  Evidence suggests that a decade after surgery, 80% of patients remain medication free and enjoy continued good quality of life. By contrast, 10 years after more traditional forms of surgery, at least 50% of patients will still be taking regular proton pump inhibitors (PPIs – strong medications).
• It is easy to reverse
  Although unlikely to be needed, if necessary the LINX device can be removed with a further minimally invasive procedure. 

What to expect post-LINX surgery

LINX is designed to provide a lifelong cure for reflux symptoms. Evidence from scientific studies suggests that up to 12 years following LINX implantation, about 70% of all patients remain significantly better off, with improved quality of life and are off all medications. So, post-surgery, you should be able to stop taking antacid medications.

You may experience some difficulty swallowing for a few weeks after the surgery. However in most cases, this will resolve.

What if LINX surgery fails?

LINX is highly unlikely to fail, as it has such a great success rate. Perhaps 1 in 200 patients will need further surgery following LINX, because of recurrent reflux.

If your reflux symptoms do return over time, in most cases it’s been found that the symptoms are much more easily controlled than they were prior to LINX. If necessary, you can re-start PPIs.

Support for reflux sufferers

Reflux can be a condition that is very difficult to live with. However, it doesn’t need to control your life. Even if LINX ultimately isn’t quite right for you, there are a lot of other treatments we can offer, based on your particular symptoms and diagnosis. We’ll talk through what’s best for you.

If you want to read more about reflux and LINX surgery, Reflux UK is a great place to start. There’s lots of tips, advice and success stories on their website.

More information

• King Edward VII’s Reflux Centre is a fully equipped unit, staffed by experts with access to the most up-to-date tests and treatments.
• Mr Nick Boyle is a specialist laparoscopic, upper GI and reflux surgeon. He has particular expertise in reflux surgery, offering the full range of surgical options including LINX. He is one of the leading LINX surgeons in Europe and has operated on more patients than any other surgeon in the UK. He and the reflux team at King Edward VII’s Hospital can provide expert treatment, advice and guidance. Make an enquiry.