What is LINXTM?

LINX is a flexible ring of small magnets placed around the oesophagus just above the stomach during a minimally invasive procedure to help prevent reflux.

How does LINX work?

The strength of the magnets helps keep the valve between your stomach and oesophagus closed to prevent reflux.  When you swallow, the magnets separate temporarily to allow food and liquid to pass into the stomach.

How is LINX different from other procedures?

LINX requires no permanent anatomic alteration, reduces gas and bloating preserves the ability to other procedures? belch and vomit and patients typically go home within 24 hours and resume a normal diet.

How is LINX implanted?

LINX is placed around the oesophagus just above the stomach using a minimally invasive surgical technique.  Many patients are able to go home the same day.

Can LINX be removed if needed?

Yes. LINX can be removed using a minimally invasive procedure and preserves patients’ future treatment options.

How do I know if I am a candidate for LINX?

Three diagnostic tests are used to determine if patients may be candidates for LINX: EGD, pH and Manometry.

When can I start eating normally again?

Patients are encouraged to return to a normal diet as soon as tolerated or as directed by their physician.

When can I return to normal activities?

Patients are generally able to return to non-strenuous activity within a couple of days.

How long will LINX last?

LINX is designed to be a lifelong implant.

Can I go through airport security?

LINX should not affect airport security.  All patients are provided an implant card to let people know they have an implant.

Can I have an MRI?

LINX patients may undergo magnetic resonance imaging (MRI) up to either 0.7-Tesla (0.7T) or 1.5-Tesla (1.5T), depending on the LINX model implanted. You should discuss the MRI scanning options with your consultant prior to deciding on treatment with LINX. LINX patients can also undergo: CT scan, x-ray, ultrasound and PET scan.

What are potential risks associated with LINX?

Achalasia (lower part of oesophagus does not relax), bleeding, death, device erosion (device passing through the oesophageal wall), device explant/re-operation, device failure, device migration (device does not appear to be at implant site), diarrhoea, dysphagia (difficulty swallowing), inability to belch or vomit,  infection, impaired gastric motility, injury to the oesophagus, 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,  vomiting, and worsening of preoperative symptoms (including but not limited to dysphagia or heartburn).

85% of patients were freed from dependence on daily GORD medication

Bothersome regurgitation was eliminated in 99% of patients

Bothersome heartburn was eliminated in 88% of patients

Patients reported a significant improvement in their Quality of Life

There are many reasons patients consider surgery as an alternative to medical therapy.

  • Are you dependent on medication to manage your reflux disease symptoms?
  • Do you continue to suffer reflux disease symptoms while on medication?
  • Is your reflux disease affecting your quality of life? (Examples: poor sleep, inability to tolerate certain foods, inability to participate in daily activities)
  • Are you concerned about the long term use of drugs to treat your reflux disease?
  • Are you concerned about the long  term risks of serious complications from your reflux disease

Talk with your physician about your treatment options if your physician determines you are not responding to medication.

Benefits

  • Durable resolution of bothersome heartburn and regurgitation
  • Requires no alteration to the stomach anatomy
  • Patients typically go home in less than 24 hours and resume a normal diet
  • Patients are generally able to return to non-strenuous activity within a couple of days
  • Reduces gassiness and bloating
  • Preserves the ability to belch and vomit

Limitations/Risks

  • Incomplete symptom relief
  • Difficulty swallowing
  • Risks related to surgery and anesthesia
  • Device failure

In addition to dietary and lifestyle changes, medication is commonly used to treat heartburn, the most common symptom of reflux disease.

Benefits

  • Reduced stomach acid production
  • Relief from heartburn symptoms
  • Reduced inflammation of the oesophageal lining

Limitations/Risks

  • May not provide adequate symptom relief
  • Does not affect the mechanical cause of reflux disease (LOS)
  • Does not prevent reflux disease
  • Side effects include: headache, diarrhoea, and upset stomach
  • Up to 40% of patients continue to have symptoms while on medication
  • Possible side effects of long-term use of Proton Pump Inhibitors (PPI) including: possible fracture risk, low magnesium levels, and clostridium difficile-associated diarrhoea

Diet Modification

  • Spicy/acidic food
  • Caffeine
  • Chocolate
  • Alcohol and tobacco

Lifestyle Modifications

  • Elevation of head of bed
  • No meals 2 – 3 hours before bed
  • Weight loss in overweight patients

Reflux disease can affect your life beyond the symptoms you feel.

Patients 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

Fundoplication surgery involves wrapping the upper part of the stomach around the outside of the oesophagus at the lower esophageal sphincter (LOS) to help prevent reflux.

Benefits

  • Reduced symptoms of heartburn, reflux and bloating
  • May heal damage to the oesophagus
  • May end dependence on medication

Limitations/Risks

  • Difficulty swallowing
  • Inability to belch or vomit when needed
  • Permanently alters the stomach anatomy
  • Typically requires hospital stay of 1-3 days
  • Symptoms may return over time
  • Requires a modified diet for several weeks
  • May limit activity for 2-3 weeks
  • Risks related to surgery and anesthesia

The Royal Marsden is leading a major clinical trial to investigate the best treatment options for patients with gastro-oesophageal cancers.

The Phase II PLATFORM trial aims to establish whether patients who have received chemotherapy will benefit from further ‘maintenance’ treatment, and whether liquid biopsies, using state-of-the-art technologies, can detect early signs of drug resistance.

The trial opened to recruitment at The Royal Marsden earlier this year and is anticipated to recruit 770 patients in up to 90 centres across the UK. Patients whose CT scans show disease stability or reduction following first-line chemotherapy will be randomly assigned to different maintenance treatment options, such as immunotherapy.

The study will also analyse tumour tissue in patients who provide consent for markers that may suggest whether they are likely to respond to treatment. Liquid biopsies will be assessed to see if drug resistance can also be identified from blood samples. This could prevent the overtreatment of patients for whom there is no perceived benefit and limit drug-related side-effects.

The trial protocol was developed by Chief Investigator Professor David Cunningham, Director of the BRC at The Royal Marsden and the ICR.

Professor Cunningham said: “This is one of the first global trials of its kind in this disease setting. There is a real need for more effective treatments, as the average survival rate for people with gastro-oesophageal cancers is just under one year with standard treatment. This is why this research is essential, and is one of the most significant pieces of research in the UK in this disease at the moment.”

Information on the optimal treatment of patients with oesophageal and gastric cancers is badly needed, given that they account for 7,701 and 4,758 deaths per year in the UK respectively, according to Cancer Research UK.

https://www.cancerbrc.org/advance/new-trial-aims-treat-gastro-oesophageal-cancers

Would you like to carry your OPA Restaurant/Toilet Card on your phone instead of in a purse/wallet/bag?

Follow the following quick and easy steps to get set up…

1) Download the OPA Restaurant/Toilet card you require from the downloads page on our website (https://www.opa.org.uk/downloads.html)

2) Once this has downloaded, click on the share button and go to “Save to Files”

3) You will then be asked to choose where you would like to save them, either in “iCloud Drive” or “On My Iphone”, pick which ever one suits you

4) And finally, go to your home screen on your phone and click into the “Files” App and the relevant folder you choose beforehand (iCloud Drive or On My Iphone) and your OPA Restaurant Cards will be ready to click on and use in any restaurant.