A cure for heartburn Stomach bracelet ends misery of reflux… and it's now on the NHS
22:21 GMT, 15 September 2012
Every day, more than seven million people in Britain suffer from heartburn, with over half of us experiencing it at some time every month.
The incidence is increasing, experts say, especially in the under-50s, probably due to richer diets, rising obesity levels and increasing alcohol consumption, which are all known aggravators.
Symptoms can include a burning or painful sensation in the upper chest behind the breastbone – explaining why it’s commonly referred to as ‘heartburn’, despite having nothing to do with the heart – a sour taste in the mouth, belching, coughing, wheezing, difficulty sleeping after eating, regurgitation, and hoarseness or a sore throat.
Pain-free: Triathlete Ben Taylor increasingly suffered heartburn until he had the LINX 'bracelet' surgery
Left untreated, chronic acid reflux, as it’s known medically, can lead to ulcers and even cancer.
Keen triathlete Ben Taylor increasingly suffered from heartburn through his 20s, especially after exercise and eating. ‘As well as the burning sensation in my throat, I suffered tightness in my chest and hoarseness,’ says the 30-year-old entrepreneur from Manchester.
‘I was prescribed drugs but nothing seemed to help in the long term. In fact, they made it worse.’
Today, Ben is pain-free thanks to a remarkable hour-long operation that involves implanting a ‘bracelet’ of magnetic beads around the upper opening of the stomach. The procedure was approved last month for NHS use.
Previously, the only option for patients with chronic heartburn was Nissen Fundoplication, which involves wrapping and stapling the upper part of the stomach around the oesophagus.
According to Dr David Ashton, an expert in weight-loss surgery at Spire Manchester Hospital, symptoms can return after ten years of having Nissen Fundoplication, and it prevents belching, leading to painful bloating.
The new procedure – called the LINX Reflux Management System – offers another solution without the same risks.
Heartburn occurs when the one-way valve at the bottom of the oesophagus called the lower oesophageal sphincter (LOS) fails to prevent digestive acids from rising back up and burning the unprotected lining of the gullet.
While there are a number of dietary and lifestyle causes such as smoking, in a large number of cases, sufferers are born with the condition. This means there is little they can do other than take strong antacid medication called Proton Pump Inhibitors (PPIs).
However, about half of people who take PPIs experience a return of symptoms within a year as the body can compensate by increasing acid production.
The new operation involves a small flexible band of magnetic titanium beads being inserted through the patient’s abdomen via a keyhole incision and placed around the lower oesophagus.
The magnetism pulls the beads together to keep the sphincter muscle closed and prevent acid rising, but the bracelet can be also be pushed apart when swallowing to allow food to descend into the digestive tract.
About 20 people in the UK have had the LINX system fitted, and around 90 per cent of them were able to stop taking any form of antacid medication immediately.
Because the keyhole surgery is minimally invasive, patients can go home the same day.
‘There’s a small chance that the bracelet could move and lose its effectiveness, but with the three years of data we have so far, that doesn’t seem to be an issue,’ Dr Ashton says.
The magnetism pulls the beads together to keep the sphincter muscle closed and prevent acid rising, but the bracelet can be also be pushed apart when swallowing
‘Questions were also raised about the metal eroding through the oesophagus wall, but we’ve seen no problems there either. Most patients who have terrible acid reflux don’t want traditional surgery, which is irreversible and problematic.
'Nor do they want the PPI medication, which can be ineffective at the same time as increasing the risk of osteoporosis and other symptoms such as nausea.’
Ben agreed to have the new operation in March last year after doing his own research and contacting Dr Ashton to arrange a consultation.
‘He explained that it was completely reversible, which meant that if for any reason it didn’t work, I wouldn’t be any worse off,’ Ben reveals.
Ben had the device fitted one afternoon two months later at the Spire Manchester Hospital. The next day he could eat full meals.
‘For the first few weeks I had to chew quite a lot to get the food to go down, but it really wasn’t a problem – with the older surgery I would have been on a liquid diet for months,’ he says.
Ben explains that it took a few months for the inflammation in his throat to settle from the years of acid reflux, but four months ago he had a pH test which showed his acid levels were normal.
Dr John de Caestecker, consultant gastroenterologist at the University Hospitals of Leicester, says that the advantage of the LINX system is that it is ‘very simple to put in and take out’.
In August, the Royal Devon and Exeter became the first NHS hospital to offer the procedure.
Surgeon Saj Wajed says: ‘Severe reflux in not only painful, it disrupts sleep, eating, drinking and social activities, and patients are at higher risk of diabetes and cancer.’
The LINX System costs 8,995 at the Spire Manchester Hospital, Spire Parkway Hospital in the West Midlands and at the King Edward VII Hospital in London. For more information on LINX, go to toraxmedical.co.uk.