LPR/Linx vs. GERD/Linx

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aciphexo
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Date Joined Apr 2011
Total Posts : 377
   Posted 8/17/2011 2:12 PM (GMT -6)   
This has probably been discussed here before, but wanted to see if more/other people have any more insights here:

Linx (when it is available in the US) can help a lot of people with "typical" GERD symptoms in the US who can't / don't-want-to take the reflux medications - however do we know if it can help people with "atypical" reflux (LPR) as well?

It seems that - since it is essentially clamping down the digestive juices (acid, bile, enzymes and so on) - it should help people with LPR as well. So, the success-rate for "curing" LPR hopefully is going to be higher than what they have for fundoplication - since the Linx device would arrest the backflow of these juices more?

Just thinking ...

Chuck T
Regular Member


Date Joined May 2011
Total Posts : 143
   Posted 8/17/2011 2:22 PM (GMT -6)   
Havent heard of any studies, but I know that both Shooz and Slicer had throat symptoms that were resolved by the LINX. I talked to Slicer the other day and he said that he is is still doing well for what its woth.

aciphexo
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Date Joined Apr 2011
Total Posts : 377
   Posted 8/17/2011 2:44 PM (GMT -6)   
As far as I know, they both *also* had GERD symptoms - right? So, it seems to me that Linx will definitely help people with "GERD+LPR" symptoms .. but what about for people with "Only-LPR" symptoms?

"Only-LPR" symptoms (that I have) are still a mystery to me ... I guess the reason is that the reflux volume of the acid is low and the throat feels it more since it has less protection. However, even in this case, the culprit is still the LES .. so if it can be clamped down when it is idle, it should help with the LPR (throat symptoms) as well ... keeping the hope alive ...

Chuck T
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Date Joined May 2011
Total Posts : 143
   Posted 8/17/2011 3:34 PM (GMT -6)   
I think you are right about the GERD symptoms. I would say that if it didnt help with throat only symptoms, then you may have some nerve related issue. I have a feeling that once this becomes available in America (and accepted by insurance companies), we will find the answer out very soon.

aciphexo
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Date Joined Apr 2011
Total Posts : 377
   Posted 8/17/2011 3:57 PM (GMT -6)   
My thinking is .. even if it is a nerve-related issue, the end result still is that it is causing the LES to open up and send the acid up to the throat. So, if this t-LESR can be clamped down with these beads - then in effect - we are negating the nerve's faulty signaling .. and therefore protecting the throat. So, if the nerve issue can not be fixed, so be it .. as long as the result of the nerve-issue can be negated (fixed) we are addressing the issue.

I think that if the PPIs help with the symptoms, then Linx should too. In the cases where acid (digestive juices) are not a factor at all - and things are purely neurogenic (hypersensitive nerves .. LSN etc.), then of course it won't.

The only issue really is .. how tight / lose does one want this device to be. For volume refluxers, light clamping will help as well .... but for LPR-style refluxers, this will need to be tighter for a good coverage on the reflux - but might mean more problems with swallowing and such?

mock turtle
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Date Joined Mar 2011
Total Posts : 467
   Posted 8/17/2011 9:01 PM (GMT -6)   
if i remember right...during the phase two trials the torax people were excluding patients who had large hiatal hernias but not excluding patients with LPR

that suggests to me, but does not prove...that they expect limited success with large hernias but believe the linx is likely to help patients with LPR

this is a guess

ill bet information from the UK, Italy, and the other country in the EU (cant remember the third country) that are currently performing this procedure, will soon provide clues as to the effectiveness of the linx for LPR

Post Edited (mock turtle) : 8/17/2011 8:06:28 PM (GMT-6)


aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 8/21/2011 4:46 PM (GMT -6)   
Yes, they say that LINX can help patients with LPR .. but likely only those who have GERD symptoms as well.

One thing I wonder about the LINX solution was:
If this is sort of a one way valve that opens with the pressure of the food bolus on its way down - then what happens to things like saliva and such .. would it collect at the LES junction - or there is enough way for it to go down into the stomach? Or does one have to constantly drink water etc. to keep things moving down into the stomach? If it is sort of open for smaller / lighter things to continue to go down - then would it cause a little bit of acid to come back up? Even a little bit of acid can give LPR symptoms ...

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 8/23/2011 6:35 PM (GMT -6)   
I see no reason why a wireless remote controlled LINX-like device is not possible. The remote control could send a signal to tighten the device when not eating and to open it up when eating. Some sort of long term battery / cells will be required to provide enough power to do this. Technologies exist and in terms of medical complications, I doubt if they will be that much different from this current device. I feel such a device is possible in not too distant future.

Jeronimo
Regular Member


Date Joined Apr 2011
Total Posts : 76
   Posted 8/23/2011 10:19 PM (GMT -6)   
PPI-LESS, I thought the same thing! When its time to eat you just press a button (or even from a mobile app) and it opens, when you finish you press the closing button. Simple.

The bad thing is to imagine that you hit the open button and you receive a signal from the device inside you body that its now open but its not working...you swallow and it wont go pass your LES and since its not working, they would have to take it out!

Im imagining the worst...but yes, it could be awesome! Im sure ToraxMedical, the LINX designers, have thought about it already.

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 8/24/2011 6:35 PM (GMT -6)   
LINX does sound promising .. but just for the sake of completeness, I wanted to list the risks/problem areas that should be considered:

- No MRIs
More testing is being done, but as of now they do not recommend that people with LINX should get MRIs done (MRI is contradicted).

- Migrations/Erosions
No erosions or migrations have been reported so far. However, we don't have enough data on this yet. The Angelchick prosethsis from a few decades back reported migrations and erosions 10+ years later. However, that device surely was an ancient technology and according to a paper written on LINX: "it is likely that the miniature size of the LINX, its “Roman arch” design and its dynamic properties allow it to mimic the physiologic motion of the esophageal wall, thereby minimizing the likelihood of tissue injury or erosion. Long- term evaluation is needed to confirm this theory."

- Dysphagia
This seems to resolve in 90 days or so ... and may occasionally cause problems .. but in general is not that bad (as per some of those who've got this done)

On the +ve side, one can always explant it out if there are any problems ..

LocalGuy23
Veteran Member


Date Joined Sep 2011
Total Posts : 620
   Posted 9/15/2011 9:54 PM (GMT -6)   
What qualifications would you need for linx? I myself is a 28 year old who is getting relief from meds. Thamks

aciphexo
Regular Member


Date Joined Apr 2011
Total Posts : 377
   Posted 9/16/2011 5:43 AM (GMT -6)   
What I've heard is that you need to something along the following lines: 1) have pathological GERD or LPR - as demonstrated in the pH test 2) have normal esophageal motility as demonstrated in the manometry test 3) not have barretts 4) not have hernia beyond a certain size (I dont know the max size).

However, if you are here in the US, they (in Europe) won't be able to work with you. You'll have relocate and be domicile of a different country and work with them from that country.

khartman
Regular Member


Date Joined Jun 2013
Total Posts : 21
   Posted 8/18/2013 3:21 PM (GMT -6)   
Any up-to-date data on how LINX works on LPR?
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