LINX procedure helps patients with GERD live more comfortably

Northwestern Medicine
Gastroenterology February 22, 2021

For 15 years, 40-year-old Charles Kolliker dealt with heartburn and acid reflux on a daily basis. Thanks to a laparoscopic procedure called the LINX procedure, the constant burning in his chest and throat is now just a memory.

Gastroesophageal reflux disease (GERD) is a condition in which the contents of the stomach flow into the esophagus, causing symptoms such as heartburn, chest pain, difficulty swallowing, dry cough and/or sore throat. GERD affects 40 percent of Americans, and approximately 20 million people have pursued medical management. Although a surgical cure has been available for decades, most patients choose to use medication to manage their GERD.

“Over-the-counter medication doesn’t treat the underlying problem,” says Anthony Altimari, MD, general surgeon at Northwestern Medicine Central DuPage Hospital. “It neutralizes the acid coming up from your stomach, but it’s still coming up. Surgical management is the only way to stop the reflux from occurring.”

Medication became part of Kolliker’s regular routine. He took omeprazole, a proton pump inhibitor (PPI), once a day for more than a decade.

“If I went one day without taking the pill, it felt like a volcano inside me,” he recalls. “But I didn’t want to be on a PPI my entire life.”

Kolliker started exploring other treatment options for GERD, which led him to Dr. Altimari and the LINX procedure. In addition to GERD, Kolliker had a hiatal hernia, a condition in which the stomach bulges up into the chest through an opening in the diaphragm, which is a muscle that separates the two areas.

After going through a series of tests, Dr. Altimari determined Kolliker was a good candidate for LINX, which involves a string of metal beads that are drawn together by a magnet. When this string is placed around the lower esophagus, the magnet pulls the beads together and closes off the esophagus from the stomach.

The LINX device is a small string of metal beads pulled together by a magnet.When the patient swallows, the beads separate to allow food to pass into the stomach. The magnet then draws the beads back together to keep acid from going up into the esophagus. Kolliker had one surgery to both repair the hernia and complete the LINX procedure.

“The recovery was very easy,” Kolliker said. “I was on pain medicine for maybe two or three days. I’ve had no acid reflux or heartburn since and am very happy I went through with this.”

LINX is offered by a select group of surgeons in the area, and the success rate for the procedure is very high. Of the patients who undergo this procedure, 90 to 95 percent are able to stop taking medication completely and the remaining 5 to 10 percent rarely take medication.

“There are several advantages to this surgery over previous approaches,” explains Dr. Altimari. “The recovery is quick, and patients commonly go home the same day. While previous surgical approaches required patients to follow a liquid diet for up to two weeks following surgery, patients are encouraged to eat right away after the LINX procedure.”

Patients 21 years of age and older who are healthy enough for surgery may qualify for LINX. All patients must undergo pre-surgical testing to determine their candidacy. These tests include:

  • Upper GI barium swallow
  • Upper GI endoscopy
  • Esophageal motility study to determine if the esophagus is the actual cause of GERD
  • 48-hour acid test to determine the frequency of reflux events

Patients who do not qualify for LINX may be candidates for the more traditional laparoscopic procedure performed by Dr. Altimari and other surgeons across Northwestern Medicine. Offering LINX is just one part of the movement toward establishing a more comprehensive GERD center at Central DuPage Hospital.

“GERD is a significant health problem in the U.S., and care has been very fragmented,” says Dr. Altimari, noting that some people self-treat with medication and others pursue treatment through a primary care physician or GI specialist. “We’re excited about putting together a comprehensive reflux program to better serve patients and physicians.”

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