Steve from Austin, TX sent us this question: “I had the LINX procedure about 5 years ago. I’m a singer. The first 4 years everything was awesome. Now suddenly I literally can’t go one night without reflux no matter what. I’ve tried everything recently with zero results. I’m wondering if something happened with the LINX”.
Like any mechanical device, LINX device may break down over time. A simple X-ray study can detect device failure. LINX device may also migrate up into the chest or erode into the esophagus leading to recurrent acid reflux symptoms like heartburn, hoarseness, sore throat and voice fatigue.
A potential long-term complication of LINX surgery is related to esophageal failure. LINX device creates a high pressure and low compliance zone around the lower esophageal sphincter. In addition to scar tissue formation, the bracelet of magnetic beads results in a barrier against food bolus movement during swallowing. Initially, a healthy esophagus overcomes this barrier. Overtime, however, esophageal contractions may start to weaken leading to esophageal failure, dysphagia, and development of acid reflux related symptoms. Heartburn may be the first presenting symptom. Evaluation consists of esophageal manometry, and UGI contrast study. Treatment relies on LINX device removal and conversion to a floppy and short Nissen or Toupet fundoplication.