One of the newest procedures for treating gastroesophageal reflux disease (GERD) involves magnets. The LINX Reflux Management System is a bracelet of titanium-coated beads with a magnetic core. A surgeon does a laparoscopic surgery, which includes making a small incision in the upper abdomen to gain access to the area at the top of the stomach and bottom of the esophagus, the area just below the sternum.
Then she places the bracelet around the lower end of the esophagus. Patients are usually sent home the same day.
The LINX device works just like a magnet — it attracts opposite sides of the esophagus together to close it up. This closure prevents gastric contents from moving up the esophagus. Yes, the magnets are powerful, but they can pull apart to allow normal swallowed material to make it into the stomach.
Early data on the device look good, but — as you can probably guess — it’s not perfect. During early clinical studies on this new device, 100 patients who had severe GERD for an average of 13 years and experienced around 80 heartburn attacks a week were examined before the procedure and 12 months after the procedure.
In just over half the patients, the amount of time that the esophagus was exposed to acid fell by at least one-half; these patients reported that their quality of life improved as well. Three-quarters of the patients experienced side effects, the most common being difficulty swallowing, which in some cases took six months or more to resolve.
The second most common side effect was pain. In five patients, the device had to be removed.
Don’t ask for a LINX if you have allergies to metals such as iron, nickel, titanium, or stainless steel. Also, after you have it put in, you can never again have a magnetic resonance imaging (MRI) scan because the uber-powerful magnets in an MRI scanner don’t play well with the metal in the LINX.
The LINX system is also problematic for patients receiving electrical implants such as defibrillators or pacemakers or undergoing insertion of metallic implants in the abdomen. The LINX device is also not recommended in patients with large hiatal hernias — large here is defined as bigger than 3 cm.
The LINX device is still very new, which means it hasn’t been tested by time or large numbers of patients.
Never be an early adopter of new technology unless you have no other option.