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Ending Acid Reflux: New treatment offers permanent relief

Millions of Americans deal with daily heartburn caused by gastroesophageal reflux disease, or GERD. For many, losing weight, adopting a healthy diet and taking medication are enough to control their symptoms. For others, surgery is needed to restore quality of life. While a decade ago the only surgical option was fundoplication, today patients have several highly successful choices, the newest of which is called LINX.

Nikolai Bildzukewicz, MD, a board-certified foregut surgeon with the St. Jude Comprehensive Digestive Health Center and a national expert in the LINX procedure, answered some common questions about the procedure. Dr. Bildzukewicz is widely published for his innovation in the treatment of acid reflux.

What is LINX?

The LINX device is a quarter-sized ring of magnetic beads that is surgically placed around the end of the patient's esophagus. Swallowing temporarily breaks the magnetic bond between the titanium beads so that food can easily enter the stomach. Magnetic attraction then causes the beads to close so stomach acid can't flow into the esophagus.

While medications reduce the acidity of the reflux, the LINX procedure corrects the cause of reflux: a malfunctioning lower esophageal sphincter, or LES. The LES is a circular bundle

of muscles that allows food and liquid to flow one way, from the esophagus into the stomach. When the LES is weak or doesn't close completely, caustic stomach acids flow backwards into the esophagus. By increasing the strength of the LES, the small LINX device restores the body's natural barrier to reflux.

Why should someone with GERD consider LINX?

If your symptoms aren't controlled by medications or you are concerned about the side effects of remaining on medications for a lifetime, the LINX procedure should be considered. Studies show more than 90 percent of patients see their reflux symptoms disappear after having this outpatient procedure.

Equally important, by eliminating the source of acid reflux, the LINX procedure can prevent further esophageal damage and halt the progression to esophagitis (inflammation and ulcers of the esophagus), strictures, pre-malignant lesions (Barrett's esophagus) and cancer. While esophageal cancer remains uncommon, it is among the fastest-growing cancers in America, and most people are unaware of the role acid reflux often plays.

If your GERD is caused or worsened by a hiatal hernia (which makes your stomach bulge up into your chest through an opening in your diaphragm), LINX offers another benefit: the hiatal hernia can be repaired during the same procedure.

What is the recovery from LINX like?

LINX is a minimally invasive procedure performed through five small incisions in under one hour, and patients often go home the same day. Unlike the restrictive diets typically required with GERD surgery, with LINX we want you to eat as normally as possible as quickly as possible.

In fact, eating for LINX patients is much like physical therapy for a joint replacement—the frequent expansion and contraction of the LINX device prevents scar tissue from developing. Patients are encouraged to snack often on foods such as fruits, yogurt, eggs and crackers and, within three to four days, are back to a regular diet.

Is heartburn always a symptom with GERD?

No, about 20 percent of those with GERD don't experience heartburn or regurgitation. Instead, their symptoms include a lump in the throat, voice changes, a persistent cough or wheezing (often mistaken for asthma). Other symptoms can include frequent ear or sinus infections, gum erosion and chest pain.

In fact, one-third of emergency department visits for chest pain are actually due to reflux.

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