Magnetic Implant May Ease Chronic Acid Reflux
Performed by an experienced surgeon, that procedure is very effective, said Dr. F. Paul Buckley III, director of general surgery at the Heartburn and Acid Reflux Center, Scott and White Clinic in Round Rock, Texas.
The problem, though, is that the surgery creates a rigid ring around the esophagus, explained Buckley, who was not involved in the new study. That often leaves patients with difficulty swallowing or with other natural bodily functions -- including belching and vomiting.
The LINX device, Buckley said, is designed to be "dynamic," expanding when food passes through, then quickly contracting again to prevent reflux.
"I think this will have a significant effect on how we treat GERD," Buckley said.
However, the device is not without problems: Two-thirds of the study patients had difficulty swallowing at first, although that dropped to 11 percent after one year, and 4 percent after three years.
Six patients had more serious side effects, including four who had the device removed -- mostly for substantial problems with swallowing. Two other patients had the device removed for "disease management," the study noted.
"The device seems to be a reasonable and fairly effective alternative," said Dr. Sigurbjorn Birgisson, a gastroenterologist and director of the Center for Swallowing and Esophageal Disorders at the Cleveland Clinic.
It might be an option for people who do not find relief from medication -- or cannot stick with long-term drug treatment because of side effects or expense, according to Birgisson, who was not involved in the study.
He added, though, that there should be further studies that compare the device with existing therapies, and look at the long-term effects.
Ganz agreed. The long-term risks are one question. So far, Ganz said, none of the patients in this study has seen the device erode or "migrate" from its intended location. But they have only been followed for a few years.
For his part, Buckley noted that there is a long history of failed therapies in the GERD world. One example is the Angelchik prosthesis, a doughnut-shaped silicone implant developed in the 1970s that wrapped around the junction between the esophagus and stomach. At first, it seemed to work well, but then doctors found high rates of longer-term complications; many people had lasting problems with swallowing, and in some cases the device eroded or slipped out of place.
The LINX device is designed much differently, but no one yet knows how it fares in the long run.
The estimated cost of the device was not available at publication time. The procedure is not currently available at most hospitals. Right now, Buckley said, only certain medical centers in the United States offer it.
Learn more about GERD treatments from the U.S. Agency for Healthcare Research and Quality.