GERD treatment

Many people experience occasional acid reflux, but having chronic GERD (gastroesophageal reflux disease) is painful and can disrupt your life.

GERD happens when the lower esophageal sphincter muscle between your esophagus and stomach is weak and doesn’t stay closed after you eat. That allows acid from your stomach to escape into your esophagus. This causes:

  • Pain or burning in your chest (heartburn).
  • Problems swallowing.
  • Sore throat.
  • Regurgitation.

The LINX® Reflux Management System is a newer GERD treatment that can improve many of your symptoms and quality of life. Bariatric surgeons offer this procedure at UPMC Hamot.

Read on to learn more about this treatment and see whether it might be a good option for you.

How the Procedure Works

The LINX® device is a ring of tiny bead-like magnets on a thin titanium wire. It looks like a small bracelet. The ring goes around the outside of your esophagus where it helps to strengthen and support your lower esophageal sphincter muscle.

UPMC Hamot bariatric surgeons use laparoscopic, minimally invasive surgery to place the device around the lower part of your esophagus. They make tiny incisions in your abdomen to access the area around your esophagus where it meets your stomach. Then, they wrap the band of magnets around the lower part of your esophagus.

Swallowing forces the magnets to separate whenever you eat or drink. Then, they pull back together to close your esophagus afterward. This keeps stomach acid out of your esophagus and in your stomach where it belongs.

Once it’s in place and you’re recovered from the procedure, you won’t feel the device. You can eat and drink as you usually would. Also, the procedure is permanent, so you won’t need to have the device replaced.

Patients who have this treatment often report improved symptoms, with less need for medicine and a better quality of life.

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Who Can Benefit from this GERD Treatment?

You can often manage GERD with a combination of diet, lifestyle, and medicine. These strategies can include:

  • Avoiding carbonated beverages, caffeine, and alcohol.
  • Avoiding spicy or acidic foods if they worsen your symptoms.
  • Eating smaller meals.
  • Try finishing eating at least 2 to 3 hours before bedtime.
  • Quitting smoking if you smoke.
  • Losing weight if your BMI exceeds 25.
  • Elevating the head of your bed when you sleep.
  • Using medicines to reduce stomach acid, if recommended.

If you’ve tried all of these but your GERD doesn’t improve, your doctor might recommend the LINX® treatment. Those who can’t use or don’t want to rely on long-term antacid or acid-blocking medicines might also benefit from this procedure.

It’s vital to manage chronic GERD symptoms. Not only is persistent heartburn uncomfortable, but also it might lead to these more severe complications:

  • Aspiration, or breathing in regurgitated stomach contents, especially while you’re asleep.
  • Sores or ulcers in your esophagus.
  • Barrett’s esophagus – changes in the lining of your esophagus.
  • Tooth decay from acid in your mouth.

What to Expect Before and After the Procedure

Your doctor will want to make sure you’re a good candidate for this GERD treatment. That’s why they may order some or all of these tests beforehand to check how your esophagus works:

  • An upper GI endoscopy. A tiny camera on a long, flexible tube examines your esophagus and stomach to ensure there are no abnormalities.
  • Esophageal manometry. A thin tube measures the pressure and muscle contractions in your esophagus to see how well it’s working.
  • Esophageal pH monitoring. A thin probe passed through your nose into your esophagus measures the acid levels in your esophagus. You might wear the probe for up to 24 hours to measure acid levels over time. Alternatively, your doctor may place a capsule with a pH transmitter in your esophagus to measure acid levels over time.
  • Esophageal imaging (Barium swallow study). A technician takes a special x-ray of your esophagus after you swallow a drink that contains barium. Barium is a chalky liquid that coats your esophagus and looks white on an x-ray. It helps your doctor to see abnormalities in your esophagus better.

The results will help determine whether this procedure is right for you. It’s not a good choice if you have any swallowing or esophageal muscle problems. It’s also not recommended if you have:

  • Allergies to certain metals.
  • Implants containing electromagnetic circuitry, such as a pacemaker.
  • A large hiatal hernia, which is when the top part of your stomach bulges through your diaphragm muscle and into your chest area. If your hiatal hernia is larger than 3 cm, your doctor might repair it before placing the device.
  • Barrett’s esophagus.
  • Severe inflammation or erosion in your esophagus.
  • Cancer or are in remission from cancer. You may not be able to have certain needed MRIs to monitor your condition if you have the LINX® device in your body. You can have an MRI if the strength is 1.5 Tesla (T), but not 3T because the machine has a stronger magnet.

The surgery to place the device takes about an hour and is generally well-tolerated. Most people can return to regular activities within a few days.

You’ll have to hold off on any ab exercises for 3 to 6 weeks until your incision and abdominal tissue heals. Your doctor will let you know when it’s safe to return to your regular activities.

The laparoscopic incisions in your abdomen are very small, but you might have a little bit of pain afterward. Also, since you’ll receive general anesthesia, you might feel dizzy, groggy, or nauseous when you first wake up. Your medical team will monitor you and provide medicine to make you feel better if needed.

It’s important to note that this device can interfere with some MRI tests. If you need an MRI in the future, make sure you tell the doctor or technician about your device.

Side effects are uncommon, but as with all surgeries, side effects or risks might occur with this procedure. Your doctor will review these with you.

If you’ve been unsuccessful in managing your GERD symptoms with standard therapies, talk to your doctor. They can let you know if you might benefit from this procedure or other GERD treatments.

LINX® is a trademark of Ethicon, Inc.

Sources

National Institute of Diabetes and Digestive and Kidney Diseases. Acid Reflux (GER & GERD) in Adults. LINK

Scientific Reports. Six to 12-year outcomes of magnetic sphincter augmentation for gastroesophageal reflux disease. LINK

Johnson & Johnson Medical Devices. LINX® Reflux Management System. LINK

About UPMC Bariatric Services

UPMC Bariatric Services is here to help if you’re struggling with obesity and want to lose weight. We offer both surgical and nonsurgical weight loss plans and can help you find the right path for a weight-loss journey. We will work with you to discuss your needs and develop and individualized treatment plan. We meet the highest level of national accreditation for bariatric surgery centers, and our team provides complete care. We offer our services at UPMC locations throughout Pennsylvania and New York. Visit our website to find a provider near you.

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