Keeping Heartburn on the Down-low

Acid reflux magnetic device keeps acid from going up esophagus

(RxWiki News) Medicines to decrease heartburn and prevent stomach acid from forming don’t work for everyone. A new method might help fill the void where these medicines leave off.

New research showed that a magnetic "bracelet" placed around the opening of the top of the stomach helped prevent heartburn in 93 percent of patients who tried the device.

This alternate treatment might be key in reducing chest pain in the 40 percent of acid reflux patients who don't respond to proton pump inhibitors.

"Ask your doctor about the LINX system."

The LINX Reflux Management System is a bracelet-like device with magnet beads that wraps around the opening sphincter between the stomach and the esophagus, the tube that connects the mouth to the stomach.

The device helps keep the esophagus closed. It takes less than an hour to insert and opens as individuals swallow to allow food and vomit to pass. The FDA approved the device in March 2012.

Researchers, led by Robert Ganz, MD, from Minnesota Gastroenterology in Plymouth, Minnesota, tested how well the device reduced heartburn in 100 adult patients with a history of acid reflux disease.

The aim of the study was to normalize acid exposure to the esophagus or reduce heartburn by 50 percent within a year after inserting the device.

Researchers also strived to improve patients' quality of life in relation to their acid reflux and reduce their use of proton pump inhibitors by 50 percent.

Proton pump inhibitors are medications that block an enzyme in the wall of the stomach that's responsible for creating stomach acid. The patients included in the study had partially responded to proton pump inhibitors in treating their heartburn.

Though the proton pump inhibitors can help with heartburn, it is ineffective for up to 40 percent of patients with gastric reflux.

Patients were followed over a five-year period and surveyed on their quality of life related to their heartburn, including burping, vomiting and regurgitation both before and after treatment.

Researchers found that acid reflux symptoms improved with the device insertion.

With the treatment, proton pump inhibitors also decreased at least 50 percent in 93 percent of the patients.

Quality of life also improved by at least 50 percent amongst 92 percent of the patients.

"The sustained control of regurgitation implies control of both acid and nonacid reflux," researchers wrote in their report.

"The procedure preserved the ability to belch and vomit in most patients. These outcomes were similar in academic centers and community centers, suggesting that the technique of implanting the device can be standardized."

Difficulty swallowing was the most frequent adverse effect from the device. Troubles swallowing occurred in 11 percent of patients during the first year after treatment and in 4 percent of patients after three years.

Among the patients who had trouble swallowing, 19 had their esophagus dilated or opened wider to improve their ability to swallow.

The magnetic device was removed from six patients who had more serious problems swallowing. One vomited intermittently and continued to do so even after the device was removed.

Researchers acknowledge the concern about having a foreign device in the body and possible erosion, but "to date, no erosions or migrations have been reported," according to researchers.

The researchers noted that their study did not compare other kinds of acid reflux therapy in a randomized experiment, which may bias their results. They wrote that future research should include larger numbers of people and look at the effects of the device over a longer period of time.

The study was published online February 21 in the New England Journal of Medicine. Torax Medical, which supported the study, contributed in designing the investigation along with its investigators and the FDA.

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Review Date: 
February 20, 2013