Chew on This: It may be easier to have surgery than to take antacids for the rest of your life
With Americans spending more than $10 billion dollars on prescription medication for heartburn and acid reflux, it’s a growing health and financial concern.
“If you have good symptom control, and no ongoing damage to your esophagus, by all means, continue. But if you are taking medication and still having breakthrough symptoms, such as waking up in the middle of the night, you should look at some other options,” said Dr. Jared Brooks, from Sentara Surgery Specialists in Norfolk.
Dr. Brooks, along with colleague Dr. Bethany Tan, are the first surgeons in Hampton Roads to be trained and able to offer the LINX procedure, an option approved by the FDA more than 5 years ago. Brooks said that not all patients have heard of this option and he’s eager to share more about how it works.
“This is for people unhappy with the prospect of lifetime medication or lifestyle modification who want something different. That’s the role LINX fulfills,” he said. “This minimally-invasive procedure helps keep the acid from creeping up the esophagus by keeping it closed with a band of magnetic beads.”
The magnetic beads are coated in titanium and connected with individually attached titanium arms for strength. It’s sized by the number of beads – with 5 different sizes, specifically measured for the outer wall of the esophagus of each individual prior to surgery. Titanium is used in other medical procedures such as joint replacements because it is inert and well-tolerated in the human body. The titanium coating completely covers each bead, and the clasp is secure.
“The clasping mechanism is like a jewelry clasp. It can’t come undone without a very specific motion that the esophagus does not make,” Brooks said. The procedure is reversible, should the desired effects not be achieved, and the device is also relatively easily replaced, if that is necessary.
How does it work?
It takes advantage of the difference in pressures between your stomach, and the pressure it takes for swallowed food to be propelled down your esophagus to your stomach.
“Your stomach at rest has a pressure of about 8 to 10 mm of mercury – that’s how pressure is measured—and your esophagus has about a pressure of 40-50 mm of mercury. LINX was created to need 20 mm of mercury to pop open. So it’s higher than stomach, which prevents refluxing up from stomach, but it will easily separate with force generated by a swallow to allow food to enter the stomach.”
For the approximately 10 percent of people who have abnormal esophageal function – they may think about other options. There are some other anti-reflux surgeries tailored for this situation. But for the 90 percent of people with normal esophageal function, LINX is an option.
How do you know if you are a candidate for LINX?
Dr. Brooks said that if you take medications such as Prilosec®, Nexium® or Zantac® (known as a type of drug called proton pump inhibitors or PPIs) occasionally and your symptoms are resolved, you may be able to wait to take action. But if you are taking medications regularly and are still having breakthrough symptoms – that is a good reason to seek out the opinion of a gastroenterologist.
“One symptom that’s not frequently recognized is asthma-like symptoms and recurrent lung infections. Many doctors believe adult onset asthma is caused by reflux until proven otherwise. So look for shortness of breath, wheezing, coughing, burning chest pain or burning bitter fluid up to the back of your throat, these may be signs of acid reflux,” said Brooks.
If you are taking medications regularly and still having inconvenient symptoms– head to see a gastroenterologist. If you are having night symptoms, such as spasms of coughing, or being awakened by regurgitation or heartburn, discuss the LINX procedure with your physician.