What is Gastric Reflux Disease?
The esophagus is the tube that connects your mouth and throat to your stomach. A unique muscle known as the lower esophageal sphincter acts as a barrier between the esophagus and stomach, only opening to let food or liquid pass through.
Gastroesophageal reflux disease (gastric reflux, acid reflux, GERD) occurs when the lower esophageal sphincter has been weakened, and harmful stomach acid flows back into the esophagus and other areas of the body. This can cause unpleasant symptoms such as heartburn, regurgitation and nausea. Left untreated, acid reflux can develop into esophageal cancer or other serious conditions.
Common Factors That Put You At Risk For Gastric Reflux
- Eating large meals or lying down after a meal
- Being overweight
- Snacking close to bedtime
- Eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
- Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea
- Being pregnant
- Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medications
Symptoms of Gastric Reflux
- Frequent burning heartburn or chest pain
- Chronic wheezing/dry cough
- Bloody vomiting
- Hiccups that don’t stop
- Difficulty swallowing
- Chronic sore throat
- Bad breath
Fundoplication surgery is commonly used to treat gastric reflux symptoms caused in part by a hiatal hernia, which is when part of the stomach pokes into the chest cavity.
During fundoplication surgery, the top of the stomach is wrapped around the lower portion of the esophagus, where it is sewn into place. The procedure repairs the natural anti-reflex barrier, preventing stomach contents from ‘refluxing’ back into the esophagus.
Fundoplication surgery has been shown to provide long-term relief of gastric reflux symptoms in approximately 87 percent of patients.
Fundoplication is routinely performed laparoscopically, using several small incisions instead of a single large incision—allowing for less pain, a quicker recovery, and smaller scars.
During laparoscopic fundoplication surgery, gas will be injected into your abdomen, giving your surgeon a clear view and more room to work. If present, the hiatal hernia will be repaired. This involves tightening the opening of your diaphragm with stitches.
After the hernia is repaired, the upper part of your stomach will be wrapped around the end of your esophagus and sutured in place. This will create pressure at the end of your esophagus, preventing acid and food in your stomach from flowing back up.
Fundoplication surgery is commonly performed under general anesthesia, which puts the patient in a deep and painless sleep. The surgery typically takes 2 to 3 hours, and most patients are able to leave the hospital within 1 to 3 days of the procedure.
Fundoplication is intended to offer lasting relief from gastric reflux. Patients have reported many benefits from the procedure:
- 70% of patients no longer depend on gastric reflux medication
- 87% of patients remain free of significant gastric reflux after five years
- 90% of patients consider the long-term outcome of their fundoplication surgery “good or excellent”
Complications from fundoplication surgery may include anesthesia-related problems, fever and infection, bleeding, trouble swallowing, a return of the hiatal hernia, bloating, nausea, an inability to burp or vomit, and damage to the stomach or esophagus.
How does the procedure get its name?
Fundoplication refers to the upper part of the stomach (the fundus) which is wrapped around the lower esophagus during surgery.
Do all people with gastric reflux have hiatal hernias?
No, most people with gastric reflux do not have a hiatal hernias. However, if there is a hiatal hernia present, it will be repaired during fundoplication surgery.
How will I need to adjust my diet after surgery?
To prevent food blockages in the esophagus, patients should stick to a non-carbonated liquid diet for two weeks, followed by two weeks of soft foods. After about four weeks, you can expect to resume a normal diet of solid foods.
When can I shower following surgery?
If you’ve undergone a laparoscopic fundoplication surgery, your small incisions are closed with an absorbable suture and glue. It is usually advised that you wait a day after surgery before showering.
Will I be able to burp following surgery?
In many cases, patients do have difficulty burping. This is because the purpose of fundoplication surgery is to create a one-way valve in the esophagus. However, symptoms can be managed through changes made to eating habits.
How long will I need to take off from work?
One to two weeks off from work is sufficient for most patients.
Will I receive postoperative support from Surgical Associates?
Yes, all fundoplication patients receive support from Surgical Associate’s gastric reflux team, including follow-up appointments as directed.
Linx Reflux Management System
Many people suffering from gastric reflux initially treat it with acid-suppressing drugs called proton pump inhibitors (Prilosec, Nexium, Prevacid, etc.). Medications like these help control the buildup of acid but do nothing to address the underlying cause of a weakened esophageal sphincter.
If taking the medication has not eliminated the debilitating symptoms of gastric reflux disease, it’s time to consider a more effective and longer-lasting solution offered by fundoplication or the LINX Reflux Management System.
Unlike other procedures used in the treatment of gastric reflux, the LINX system requires no altering of the stomach. It is implanted laparoscopically and consists of a small a band of magnetized titanium beads that wrap around the base of the esophagus. The band prevents stomach acid from being pushed into the esophagus but also expands and contracts for easy swallowing.
The LINX system is a permanent, drug-free solution that helps get patients back to a normal lifestyle unrestricted by gastric reflux.
Long-Term Benefits of Linx
- EASES symptoms of heartburn and regurgitation
- LESSENS instances of acid exposure to the esophagus
- REDUCES or ELIMINATES the need for gastric reflux medications
During the procedure, you will be sedated using anesthesia, and the LINX system will be implanted around the base of your esophagus. To ensure a proper fit, your esophagus’ diameter will be measured using a special tool. Once the esophagus is measured, the tool is removed, and the LINX band is implanted. It will be wrapped around the esophagus, with the ends securely linked. Most patients return home the same day as the procedure.
The LINX implant is intended to offer lasting relief from gastric reflux. Patients have reported many benefits from procedure:
- 85% of patients no longer depend on daily acid reflux medication.
- 88% of patients no longer experience heartburn.
- 99% of patients no longer experience regurgitation.
Overall, there has been a significant success rate for the LINX system, and most patients report they have an improved quality of life following the procedure.
The risks associated with the LINX system are low. Complications related to the LINX system include bleeding, infection, allergic reaction, cardiac arrest, device erosion, device migration, esophageal spasms, and indigestion. If you experience negative side effects following the procedure, the implant can be taken out at any time. Your doctor will discuss all of risks and benefits of the LINX system with you prior to the procedure.
To be a candidate for the LINX system, patients CANNOT be under the age of 21, pregnant, or are allergic to metal. You also cannot be treated with LINX if you’ve had previous esophageal surgery. Patients with Barrett’s esophagus (pre-cancer) may get the LINX implant with their doctors’ approval.
How long does the procedure last?
Approximately an hour
Will the device ever need to be removed?
The implant is designed to be permanent, but if you experience any complications, it will likely be removed.
Will I still have to take heartburn medication?
Only 10% of LINX patients have had to continue taking daily medication following the procedure.
How soon after the procedure can I eat?
You should be able to eat within 24 hours.
How soon after the procedure can I resume normal physical activities?
Routine daily activities can begin within a few days of surgery, after any pain has subsided and there is no longer a need for pain medication. Workout activities requiring the use of the abdominal muscles should be put off for three to six weeks.
Is there any risk the implant will be too tight and cause food to get stuck?
Only 3% of patients experience this. It will result in the removal of the implant.
How long will LINX last?
It is designed to last for a lifetime.
Will I be able to feel the implant after the procedure?
A small number of patients have reported that they felt sensations around the area where the LINX device is implanted. These sensations generally go away over time.
I know I have gastric reflux. Why do I need additional testing before the procedure?
It is essential to know whether or not the muscles in the esophagus generate enough pressure to open the LINX magnetic ring.
Will my insurance company pay for LINX?
Nearly all insurance companies pay for anti-reflux surgery. However, LINX is a new procedure, so we are working closely with the insurance companies as they learn about the procedure.
Will I run into problems trying to go through security at the airport?
All patients are given a card stating they have an implanted medical device. As long as you remember it, you should have no problem with airport security.