What is the criteria for having the Linx device?

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GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 11/20/2012 8:00 AM (GMT -6)   
Hi all,
 
I am considering having the Linx operation, and I am looking for as much information as possible so that I may make the best decision.
 
I have looked on the Linx site, but I can't find a specific list of Criteria that they ask for to see if I am a suitable candidate.
 
I have had my Manometry, and PH test - the consultant said something is happening but it's not difinitive! I also have a small Hiatus Hernia less than 1cm, and I get a burning tongue and burning inner bumpy lips, throat is red as is the sides of the mouth. I only occasionally feel acid in the throat, but have a feeling of a lump in the throat and trapped burps in gullet and constant gnawing in the sternum. 80mg of Omeprazole and 2 ranitidine, made no difference whatsoever.
 
I have just sent off the Pepsin Tests - thank you- JPT - and will await the outcome. Barium swallow showed monor lower tertiory contractions and reflux.
 
So, I am seeking advice to see if I would be suitable for the Linx surgery, as my quality of life is very restricted.
 
Does anyone have a list of criteria that they are looking for?
 
Many thanks.

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 11/20/2012 9:57 AM (GMT -6)   
In general the criteria are similar to those for fundoplication. Of course it all depends on the surgeon's choice, especially if it's not a textbook case.
 
Usually what they look for, for surgery, is:
- some improvement by PPI, suggesting that decreasing acid reflux will help you
- relationship between reflux and symptoms (24 hour PH impedance study)
 
Then there are some things that factor in such as:
- size of hiatal hernia
- Barretts esophagus
- motility/swallowing issues
 
I think if you look at the papers on the LINX research phase, you will find some exclusion criteria such as Barrett's esophagus and 3cm or larger HH. That is not to say that they have continued these exclusion criteia to the real world application though. They may be able to fix the HH then implant the LINX.
 
It would help to know the details of your 24 hour PH study. If it includes impedance (which most do nowadays), it can be very telling.
 
I also have burning tongue though I experience small amounts of regurgitation into my mouth, characteritsed on my 24 hr PH study by excessive "weakly acidic" refluxes and high proportion (63%) of refluxes reaching the proximal (highest) sensor. Burning tongue is usually considered atypical, though it makes perfect sense to me that the tongue would be irritated by reflux. There are plenty of papers out there listing burning tongue as a symptom, but no papers I've found where they have stated surgery will help it (but it should).
 
I also had a very tight throat, but PPI helped me immensely in that regard. If you have absolutely no help from PPI or other acid blocker, I'd wonder if it's reflux. Or it might be ONLY weakly acidic reflux which is ph<4 and can still irritate the throat/mouth.
 
 
 

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 11/23/2012 1:22 PM (GMT -6)   
Many thanks for taking the time to go into so much detail, it has really helped.
 
I think that perhaps my manometry test would exclude me from the Linx, as I'm not sure I would have strong enough lower contractions to push the food through the magnet, so I will research into other procedures.
 
When you get your burning tongue, do you have it all day? And does it also bother your lips?
 
Once again, thank you for all the information. :-)

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 11/23/2012 2:31 PM (GMT -6)   
Hi - my lips do not burn, but I have definitely noticed chapped lip issues since I had all this burning tongue/bitter taste nonsense. I can't prove it, but I think that the bitter stuff is mixing with my saliva and when that saliva meets my lips, it irritates them. And it does the same thing to my tongue.

My tongue burning is not severe, and sometimes I notice it more than others, most often it seems to be related to the sour taste in terms of severity.
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