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Reflux is a disease, not a bad meal choice.
Reflux (also called Gastroesophageal reflux disease, or GERD) is a chronic digestive disease in which acid and bile flow back from the stomach into the esophagus, creating pain and often causing damage to the lining of the esophagus.
What causes reflux disease?
Reflux disease is caused by inappropriate relaxation or weakness in a muscle called the lower esophageal sphincter (LES). Normally the LES acts like a one-way valve allowing food and liquid to pass through to the stomach, but preventing stomach contents from flowing back into the esophagus.
The most common symptom of reflux disease is heartburn. However, reflux disease can produce a wide variety of symptoms including: hoarseness, sore throat, cough, chest pain, shortness of breath, difficulty swallowing, asthma, heartburn, and regurgitation.
Patients living with reflux disease often experience:
Poor quality of sleep
Reduced work productivity
Dietary compromises to avoid symptoms
Concerns about the long-term effects of reflux disease
Life-long dependence on reflux medications
In addition to producing a wide range of symptoms, reflux disease can lead to potentially serious complications including:
- Esophagitis (Inflammation that can damage the tissue of the esophagus)
- Stricture (Narrowing of the esophagus)
- Barrett’s esophagus (Pre-cancerous changes to the tissue lining the esophagus)
- Esophageal cancer (in rare cases)†
There are several tests that your physician may use to diagnose reflux disease. Here are some examples:
- A medication trial may be used to confirm diagnosis in patients with typical symptoms.
- Esophagogastroduodenoscopy (EGD), also known as upper Endoscopy, is a test that examines the esophagus and LES for evidence of reflux disease.
- pH monitoring using a probe in the esophagus near the stomach measures the level of esophageal acid exposure.
Diet modifications to reduce or eliminate spicy/acidic food, caffeine, chococolate, alcohol and tobacoo. Lifestyle modification such as elevation of head of bed, no meals 2-3 hours before bed, and weight loss (in overweight patients).
The benefits of medication include reduced stomach acid production, reduced inflammation of the esophageal lining, and relief from heartburn symptoms. However, medication does not address the mechanical cause of reflux disease (LES). Studies have shown that up to 40% of patients continue to have symptoms while on medication.1
Traditional Anti-Reflux Surgery: Fundoplication
Fundoplication surgery involves wrapping the upper part of the stomach around the outside of the esophagus at the lower esophageal sphincter to help prevent reflux. It has been shown to reduce symptoms of heartburn, reflux, and bloating, and may also end dependence on medication.2
* LINX is not intended to cure, treat, prevent, mitigate or diagnose these symptoms or complications
† 0.5% of Barrett’s Esophagus patients per year are diagnosed with esophageal cancer
1. Rona K, Reynolds J, Schwameis K, et al. Efficacy of magnetic sphincter augmentation in patients with large hiatal hernias. Surgical Endoscopy. 2017. 31(5):2096-2102.
2. Reynolds J, Zehetner J, Wu P, et al. Laparoscopic Magnetic Sphincter Augmentation vs Laparoscopic Nissen Fundoplication: A Matched-Pair Analysis of 100 Patients. J American College of Surgeons. 2015. 221(1):123-128.
LINX® Reflux Management System Important Safety Information
The LINX® Reflux Management System is a laparoscopic, fundic-sparing anti-reflux procedure indicated for patients diagnosed with Gastroesophageal Reflux Disease (GERD) as defined by abnormal pH testing, and who are seeking an alternative to continuous acid suppression therapy (i.e. proton pump inhibitors or equivalent) in the management of their GERD.
Contraindications: Do not implant the LINX Reflux Management System in patients with suspected or known allergies to titanium, stainless steel, nickel, or ferrous materials.
Warnings: The LINX device is considered MR Conditional in a magnetic resonance imaging (MRI) system up to either 0.7 Tesla (0.7T) or 1.5 Tesla (1.5T), depending on the LINX model implanted. Scanning under different conditions may result in serious injury to you and/or interfere with the magnetic strength and the function of the device. In the event alternative diagnostic procedures cannot be used and MRI is required, the LINX device can be safely removed utilizing a laparoscopic technique that does not compromise the option for traditional anti-reflux procedures. It is recommended that patients receiving the LINX device register their implant with the MedicAlert Foundation (www.medicalert.org) or equivalent organization.
Failure to secure the LINX device properly may result in its subsequent displacement and necessitate a second operation.
Laparoscopic placement of the LINX device is major surgery and death can occur.
General Precautions: The LINX device is a long-term implant. Explant (removal) and replacement surgery may be indicated at any time. Management of adverse reactions may include explantation and/or replacement.
The use of the LINX device in patients with a hiatal hernia larger than 3 cm should include hiatal hernia repair to reduce the hernia to less than 3 cm. The LINX device has not been evaluated in patients with an unrepaired hiatal hernia greater than 3 cm.
The safety and effectiveness of the LINX device has not been evaluated in patients with Barrett's esophagus or Grade C or D (LA classification) esophagitis.
The safety and effectiveness of the LINX device has not been evaluated in patients with electrical implants such as pacemakers and defibrillators, or other metallic, abdominal implants.
The safety and effectiveness of the LINX Reflux Management System has not been established for the following conditions:
• Suspected or confirmed esophageal or gastric cancer
• Prior esophageal or gastric surgery or endoscopic intervention
• Distal esophageal motility less than 35 mmHg peristaltic amplitude on wet swallows or <70% (propulsive) peristaltic sequences or High Resolution Manometry equivalent, and/or a known motility disorder such as Achalasia, Nutcracker Esophagus, and Diffuse Esophageal Spasm or Hypertensive LES
• Symptoms of dysphagia more than once per week within the last 3 months
• Esophageal stricture or gross esophageal anatomic abnormalities (Schatzki’s ring, obstructive lesions, etc.)
• Esophageal or gastric varices
• Lactating, pregnant or plan to become pregnant
• Morbid obesity (BMI >35)
• Age < 21
Potential Side Effects: Potential adverse events associated with laparoscopic surgery and anesthesia include adverse reaction to anesthesia (headache, muscle pain, nausea), anaphylaxis (severe allergic reaction), cardiac arrest, death, diarrhea, fever, hypotension (low blood pressure), hypoxemia (low oxygen levels in the blood), infection, myocardial infarction, perforation, pneumonia, pulmonary embolism (blood clot in the lung), respiratory distress, and thrombophlebitis (blood clot). Other risks reported after anti-reflux surgery procedures include bloating, nausea, dysphagia (difficulty swallowing), odynophagia (painful swallowing), retching, and vomiting.
Potential risks associated specifically with the LINX Reflux Management System include achalasia (lower part of esophagus does not relax), bleeding, cough, death, decreased appetite, device erosion, device explant/re-operation, device failure, device migration (device does not appear to be at implant site), diarrhea, dyspepsia (indigestion), dysphagia (difficulty swallowing), early satiety (feeling full after eating a small amount of food), esophageal spasms, esophageal stricture, flatulence, food impaction, globus sensation (sensation of a lump in the throat), hiccups, inability to belch or vomit, increased belching, infection, impaired gastric motility, injury to the esophagus, spleen, or stomach, nausea, odynophagia (painful swallowing), organ damage caused by device migration, pain, peritonitis (inflammation of the peritoneum), pneumothorax (collapsed lung), regurgitation, saliva/mucus build-up, stomach bloating, ulcer, vomiting, weight loss, and worsening of preoperative symptoms (including but not limited to dysphagia or heartburn).
Torax® Medical, Inc.
4188 Lexington Avenue North
Shoreview, Minnesota 55126, USA