What Happens after LINX™ Surgery?

What Happens after LINX™ Surgery?

Harry from Houston sent us this question: “After over a year following LINX™ surgery I’m still having problems with food getting stuck.

It seems to happen mostly when I sit down to eat lunch or dinner and with certain foods.
It can be painful but I’m wondering if I’m eating too fast. I have no heartburn, so it seems to be working but at times my food gets stuck. What can I do? “

Dear Harry,

Dysphagia or difficulty swallowing is a common problem after LINX™ device placement for treatment of heartburn and acid reflux. LINX™ device, a bracelet of magnetic beads, creates a barrier against esophageal emptying of food into stomach. Flow across LINX™ device depends on food bolus pressure and esophageal wall compliance. The higher the pressure and the lower the compliance the greater is the flow. Food bolus pressure is generated by esophageal contractions. If you have weak esophageal contractions, LINX™ device placement is contraindicated. Esophageal contractions are measured prior to anti-reflux surgery using manometry. Esophageal wall compliance is not typically measured prior to surgery. Most patients with acid reflux have decreased wall compliance favoring backflow of acid into esophagus. LINX™ device placement causes increased scar tissue formation around distal esophagus. Scarring decreases esophageal wall compliance and sometimes may decrease esophagus lumen. Decreased esophageal wall compliance is a two-edge sword. It decreases acid reflux and heartburn, but it hinders swallowing. Esophageal lumen narrowing responds to balloon dilation. Esophageal wall compliance, on the other hand, may not be possible to alter without removing the LINX™ device.

Properly performed Nissen fundoplication is currently the most reliable treatment for acid reflux. Dysphagia post Nissen fundoplication surgery at Houston Heartburn and Reflux Center is very rare. A short and floppy Nissen fundoplication, unlike LINX™ device, creates very little resistance against esophageal food emptying into the stomach.