I am facing reflux surgery and finding it difficult to decide between Linx and more conventional surgery. Any comments gratefuly received. thank you.
LINX may be the best artificial alternative presently available for reflux reduction but is not as good as LNF despite some manipulated evidence in a recently published report.
It has only been around for about 10 years and has been getting a lot of free publicity as every time a clinic in USA makes this treatment available, it's published as a news story that there's this new treatment to cure acid reflux and always including the (false) claims its manufacturer makes that it's better than LNF because it's reversible and you can burp and vomit afterwards. (Which can all apply to LNF.)
The shiny metal 'bracelet' of titanium magnets that is fitted around the oesophagus in an operation similar to LNF - and has associated side effects (mainly dysphagia – which affects 63% of those who have LINX)) lasting a few weeks.
It costs about twice as much as LNF and, whereas it is available on NHS, you'd be hard pressed to find a surgeon who'll do it. It's like paying twice as much for a car that may not go and if not you can pay the salesman to take it back and pay again for a cheaper, more reliable, model.
A recent news article attempted to expose the fraud used to sell the device.
LINX has an 85% satisfaction rating over the 5 years worth of data available. LNF has a 94% satisfaction rating over the 30 years worth of data available.
40 years ago, a similar device (based effectively on a sophisticated elastic band around the oesophagus, called “Angechik”) was all the rage. Thousands were fitted as everyone thought it was the greatest invention. However, 20 years later most were clamouring to have it removed as it had started eroding the oesophagus.
The manufacturers (Torax Medical) admitted to me 6 years ago they were worried about possible migration of the device over time. And will new tisssue growing over the magnets make them inoperable and difficult to remove?
Other concerns are if you need an MRI scan this will have to be done at low power or the device removed. It is not suitable for anyone with a hiatus hernia longer than 3 cm or Barrett's Oesophagus (unless it is a very small patch).
There are many who have had the LINX implant (including, allegedly, Dolly Parton) who feel it has improved their life and I am happy for them.
I had the LNF and it gave me my life back.
I would personally recommend the tried and trusted Nissen.
Hi Barretts,
I have read a few of your posts and you seem to be in the know and I wonder if you can advise me?
I have been struggling with reflux for nearly 2 years now had umpteen tests nothing significant found apart from a 3 cm hiatus hernia and some inflammation. Do you think this hernia could be the cause of all my problems? I am taking esomeprazole and domperidone daily and Stillhave chest/back pain every single day doesn't seem to matter what I eat or drink.
Best wishes,
Lynne
Hi, Lynne,
Hiatus hernia is the most common cause of reflux. Sometimes it has formed from being overweight but some people may be born with it.
It is part of the stomach protruding through the hole (the "hiatus" in the diaphragm where the oesophaus passes from the thorax into the abdomen.
Reflux prevention is controlled by two sets of muscles: the sphincter muscles, immediately below the diaphragm surrounding the oesophagus as it meets the stomach, and the diaphragmatic muscles. A hiatus hernia impedes the operation of the latter and the extra mass of the stomach protruding where the musculature needs to exert pressure.
Hiatus hernias are very common in the population and for most people cause no real problems. However, for some, like us, it can exacrebate reflux.
If that reflux is acidic, it can cause permanent damage to the oesophagus (Barrett's Oesophagus which, in a few people, can progress to cancer). PPIs like esomeprazole will reduce the acid but not the reflux and even non-erosive reflux can cause damage and problems.
Unfortunately there is no simple answer to controlling reflux. Some years ago, the drug Cisapride was a useful pro-kinetic agent that helped. Unfortunately it increased risk of heart attack and was withdrawn for European and US use.
Domperidone and metoclopramide are two different anti-emetics which some find slightly helpful in reducing reflux. There is a new pro-kinetic in trial called Acotiamide that looks as if may be helpful.
Meanwhile these are the top tips to reduce reflux:
Lose weight if necessary.
Do not over-fill your stomach: eat little and often.
Avoid exercise after food that will compress the stomach (including bending).
Avoid tight clothing.
Leave at least 3 hours between your last meal and going to bed.
Raise the head of your bed by 6 to 8 inches on blocks.
Sleep on your left side.
If you cannot manage your reflux, you may consider the surgical option of a Nissen fundoplication. (Your hiatus hernia would also be repaired at the same time.)
All the best
Chris
It's most annoying when the auto-emoji decides to give a smiley face when it's supposed to be a closing bracket!
Hi Chris,
Thank you for your explanation and advise.
I am petite and slim build - never been overweight and have tried all the things you have suggested but still my symptoms persist.
I do suspect the hernia is causing all this and at my last appointment with a gastroenterologist he did suggest this. I am currently waiting for another endoscopy so hope this helps to diagnose and I can hopefully see a way forward.
Thank you again and best wishes,
Lynne
I have read your post could I please
Ask how you have this knowledge
About the linx procedure ?
I had the linx procedure 2 weeks ago
I did receive information about
Both procedures Nissan and the
Linx procedure and for me I
Decided the best option for me was
The linx procedure.
People need to take time to
Consider any type of surgery.
Hello Chris
I had the linx procedure 2 weeks ago so
Still early days but so far so good.
Your doctor or consultant should be able
To give you information about all the
Surgery options for reflux surgery.
I did receive information about both and
I took a full year to decide which path to
Go down the Nissan or Linx procedure
I felt the Linx procedure was the better
Option for me.
I wish you all the best and hope you feel
Better very soon .
Hi Lynne,
What tests have you had done?
Seems like most of us get the std barium swallow, 24 hr pH test and endoscopy.
I had the Nissen last year and really regret it (I must be one of the 6% LOL). Cured the heartburn but now I have a load of other problems!
There are so many causes of reflux and I wish I pushed for more testing.
Food intolerances, SIBO, H Pylori (any overgrowth of bad bacteria) and interestingly enough low stomach acid. All can be tested for and all can be treated. Another thing that has been looked at (quite successfully) is using Elavil which is an anti depressant. In some cases it can be irritation of the vagus nerve which causes reflux. The Elavil also acts on these nerves. Do you suffer from bloating/flatulence? If so I would definately look into the causes above. Too little stomach acid is just as much a problem as too much. I would try alternatives first
I have spent considerable time researching this. I have archives of research material and I have discussed this at length with many gastroneterolgist colleagues both medical and surgical. And I have spoken with the manufacturers, Torax Medical.
I am writing a book "Down With Acid" to be available as a FREE download but am ensuring the contents are factual by cross checking all evidence and having it double checked by my gastro colleagues.
The purpose is to have a resource written in layman's language by a sufferer.
There is an entire chapter devoted to LINX, Stretta, Esophyx (TIF), MUSE, Endocinch, Endostim, Enteryx, Gatekeeper, Angelchik, Reza Band, MedCline etc as well as one detailing 8 variations of fundoplication.
Hopefully the chapter will be helpful having done the research for them.
Chris did you ever try alkaline water before your procedure? Thanks for all the info.
That alkaline water can help is a myth. It is propagated by those who wish to make money out of it - the bottled water manufacturers and the devices to make it.
I gather it must be well advertised in the States as that's where I get most enquiries from. It's almost unknown in UK.
The stomach becomes a reservoir of highly concentrated hydrochloric acid when any food or drink enters the body. drinking alkaline water is like pouring a kettle of hot water into the ocean. You could physically not drink sufficient quantity of alkaline water to neutralise it.
Furthermore, if you ingest anything with a higher pH, more proton pumps are created so the stomach acidity is increased.
The hoax of alkaline water the water companies play has been exposed on a website which says, "You know a medical product is 'snake oil' when all the salesperson can do is offer outlandish claims based on testimonials and no peer reviewed studies. People are making claims that alkaline water cures cancer, heart disease, eye problems and all sorts of diseases. The manufacturers of the device however do not make these claims."
Another website states, "Alkaline water is claimed to have a range of health benefits, from supporting detoxification to protecting or curing cardiovascular diseases and cancer. Currently, there is some evidence to support the opposite, suggesting alkaline water may have a negative effect upon physical health and well-being, if any effect at all."
The only positive effect it can possibly have is as a placebo.
Quick reply. I've given a longer reply but it's gone to moderation. In copying text from one source, it may have accidentally included a weblink unintentionally.
The short answer (which I supported in the long answer) is alkaline water is a hoax and can be dangerous.
Hi Moonbuggy,
Thank you for your post. I am sorry to hear you do not think Nissan has worked well for you.
I have had numerous tests including barium swallow, PH manometry and endoscopy all showing nothing significant exept 3cm hiatus hernia and some inflammation. Sometimes I feel as though Doctors think I am making it all up!! which I most certainly am not!! Chest/back pain continues everyday and I am sick and tired of it all.
Have to keep on punching!!
Best wishes,
Lynne
Hi Chris,
Would be very interested to read your book when it is available.
It's probably about 75% complete. It occupies 86 pages and finished book will probably have between 100 and 120 pages. It is being compiled as a website here www.DownWithAcid.org.uk
The "Alpha3" version of the book is downloadable from that site but it's a large file (2826K). Click on the Image top left of any page on the site.
Thanks for all the info much appreciated. I think it depends on the type of reflux you have. From full blown mine has come down to minor acid leakage at night ZERO in the day thank heavens. My strategy for dealing with this is without any meds or antacids. Before bed I take a couple of swallows and then tiny amounts if I feel acid coming on in the night. You can train yourself to do this without waking up fully. So I am not trying to alkanise my body but just denaturing my throat to neutralise pepsin. Now it does do this really well and I feel it is better than using baking soda. It is only PH 8.22.
Sounds very interesting. What exactly do you swallow? I have similar symptons to you and if I could get away withoug susrgery that would be preferable. thanks Chris
Hi Summer
glad to know things are progressing well, helps me make up my mind which proceduure to have. Where did you have the operation?
Hi Chris
I have suffered from serve reflux
Problems for many years.
Sleeping and eating had become
Extremely difficult.
The pain was excruciating and I
Would constantly be belching.
I was sick everyday.
I also had difficulty talking due to
The acid burning my throat and
Nose. I also had serve heartburn
I had to take high dosege of
Ranitidine and esomeprazole
I also took Gaviscon throughout
The day and night.
I'm 16 days post surgery
The first week I did not feel too great
But I am now feeling much better
I'm off all medication the only issue
I have had is certain foods bread , rice
Seem to become stuck this causes a discomfort feeling for a very short
I can breath and I've been told I'm not
In any danger of choking as its
Getting stuck above the linx device.
I need to remember to chew and eat
Smaller sized bites and slower to
Help prevent this from happening
I have been told this will improve
Over time. Its the device getting
Used to opening and closing.
I've no reflux and I am very happy
That I have had the linx procedure