Chicago- Affecting one in every four Americans, gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal disease in the United States. Very little has changed in the treatment of this condition over the last several decades, until now. Last year, a new device to help treat GERD, called the LINX Reflux Management System was approved after four years of evaluation and testing by the Food and Drug Administration (FDA). Northwestern Memorial Hospital is the first hospital in Illinois and one of only a few centers in the United States to offer this procedure.
Heartburn occurs when the one-way valve at the bottom of the esophagus, called the lower sphincter, is too weak to prevent digestive acids from rising back up the esophagus. Patients with GERD are first encouraged to make dietary and lifestyle changes such as losing weight and avoiding certain types of foods that may trigger symptoms. For those who do not respond to dietary and lifestyle measures, medications are available, such as antacids and proton pump inhibitors.
“The proton pump inhibitors that are on the market right now are effective to relieve symptoms in most patients, if used correctly, ” said Nathaniel Soper, MD
, chair of surgery at Northwestern Memorial Hospital and director of minimally invasive surgery and the Loyal and Edith Davis Professor and chairman of surgery at Northwestern University Feinberg School of Medicine. “These medications are necessary to help treat GERD, but often times they don’t control all of the symptoms of GERD, and many patients experience a relapse of symptoms. Some people experience side effects or wish to discontinue the medicines for various reasons.”
When medications fail to control the GERD, surgery is an option for some patients. However, less than one percent of patients choose surgical treatment for the condition because of its potential risks and side effects.
“The most common operation for GERD involves wrapping part of the stomach around the lower esophagus to strengthen the reflux barrier and, while this is effective, it can also interfere with normal physiologic functions like belching, and vomiting, and may lead to the gas bloat syndrome ,” explained Soper. “The LINX is an option for patients who are seeking a minimally invasive treatment that offers proven clinical benefits, generally with a lower incidence of the side effects of the current surgical procedures for GERD.”
The LINX is an implantable device consisting of a bracelet of titanium beads with magnetic cores that expand and act as a replica of the sphincter muscle. The small band of beads is inserted through the patient’s abdomen using laparoscopic surgery via a few small incisions and placed around the lower esophagus sphincter. The magnetism pulls the beads together to keep the sphincter muscle closed and prevent acid rising. The beads of the bracelet can also be pushed apart when swallowing to allow food to descend into the stomach. The patient is under general anesthesia during the outpatient procedure that typically takes less than an hour using a number of very small abdominal incisions.
Unlike other surgical options, placement of the LINX system does not involve significant alterations to anatomy that may limit future treatment options. If needed, it can be removed later during a laparoscopic procedure similar to the implant procedure.
Doctors stress that treatment options must be carefully selected based on the unique needs of the patient, but say minimally invasive procedures such as the LINX operation have been shown to offer an array of potential benefits including a shorter recovery time, shorter hospital stay and less pain.
“The LINX Reflux Management System will likely be significant for select patients who have failed treatment of GERD with medications,” said Soper.
Northwestern Medicine is the shared vision that joins Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine in a collaborative effort to transform medicine through quality healthcare, academic excellence and scientific discovery.
To make an appointment with a Northwestern Medicine gastroenterologist, please call 312-926-0779 or visit www.nmh.org