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LINX™ Sphincter Augmentation Surgery

Diet and swallowing

  • We want people to resume a normal diet immediately following surgery and you will be asked to eat a sandwich or equivalent before you leave hospital following your surgery. It is important that you eat at least 2-3 normal (small) meals every day to ensure that the LINX™ is being exercised. 
  • If you are struggling, slow down: one bite every 30 seconds if things are not going down easily.
  • Swallowing may be temporarily worse around 2-4 weeks. It is important that you continue to eat regular food during this time, even if the food feels as though it s getting stuck. 
  • Please contact us if you are unable to tolerate a bite of yogurt every hour, cannot stay hydrated, or have continuous vomiting. 
  • If you become constipated it is okay to use a laxative as needed. 

There is not a specific list of foods to eat during recovery from LINX™ surgery. Each patient tolerates different consistencies at different times of their recovery, and some patients have no difficulty swallowing after surgery. Gradually increase your diet over the next weeks as your body permits. Physical therapy for the oesophagus – swallow something every few hours. 

It is a normal healing process for the body to form scar tissue (capsule) around the oesophagus and LINX™. It is essential that the scar tissue remains flexible for the LINX™ to function properly – so it needs regular stretching. To stretch the scar tissue please eat a normal diet immediately following surgery, as this will be equivalent to doing physio on your gullet. This can be uncomfortable at times, but is the most important part of your recovery, so keep doing it even if uncomfortable. You may also have 3-4 snacks between meals per day. Eat slowly – wait 1 minute in between each bite. 

It takes 30 seconds for the oesophagus to regain its strength after a swallow. If food seems to be hanging up, slow down and wait at least 1 minute between bites. Large bites are likely to have a harder time going down and are more likely to lead to spasms or hiccups. During regular meals still follow the 1 bite every minute principle. If water or other liquids are not going down well, add some food.

 The oesophagus generates better pressures with semi-solid foods and exercise the LINX™ better than liquids. If liquids are not going down well, the first thing we recommend is taking a few crackers or soft mushy foods; the higher pressures from more solid foods will often help clear the liquids as well. 

Warm or room temperature liquids tend to be more comfortable than cold. Cold liquids lead to the weakest pressures (meaning more difficult for things to go down). Small sips frequently are helpful to prevent dehydration. Sometimes a sip of carbonated beverage helps to pressurize and push food through (not more than a sip).

Swallowing may get worse a few weeks after surgery

A few weeks after surgery (generally 2 weeks), swallowing always gets worse as the inflammatory process following surgery peaks and then settles – this is normal. Even while this happens swallowing normally to keep the LINX™ opening and avoiding the development of a restrictive capsule is essential to prevent long term swallowing problems. At this time scar tissue temporarily thickens and most of the healing process occurs. Swallowing may become much more difficult during this time, but continue to eat normal meals and, if you want, small snacks between these. Please let us know if you are not able swallow yogurt consistency most (over 50%) of the time.  After a few weeks this should improve. Swallowing should slowly improve after 4 weeks. It can take some patients a few months to be “normal.”

Swallowing tablets

You may take your normal prescription medications. It is sometimes helpful to take them with yogurt or applesauce instead of water. 

If you are still having problems swallowing them, you can check with your pharmacist and see if you can crush or break them. Hold off on large vitamins or supplements until you are swallowing without difficulty.

Exercise and other activities

In general, you may resume normal non-strenuous activities as soon as you are up to it. Aerobic activities are tolerated if you can speak in full sentences. If you cannot complete a full sentence without taking a breath, you are working too hard. You should not lift anything heavy (anything you must strain to lift) for 1 month after surgery. 

Chest and shoulder pain

Sometimes patients will experience shoulder pain or deep pain in the chest after surgery. This is due in part to the gas used at laparoscopy, but more so to the sutures placed in the diaphragm muscle; and should gradually resolve. Heat applied to the shoulders tends to help this pain the best. It may be difficult/uncomfortable to take a deep breath or lie flat immediately after surgery as breathing uses the diaphragm muscle. This will slowly improve as you heal from surgery. Doing slow deep meditation type breathing will help with recovery.

Pain medication

You may be given a prescription for a narcotic pain relief and/or anti-inflammatories and anti-nausea medication. Please speak to the Pharmacist at the hospital if you have any queries prior to your discharge. You may resume other medications you were on prior to surgery. Your surgeon will be able to advise you whether to discontinue any heartburn medication.


You will have typically 4/5 small incisions between your belly button and your rib cage. The incisions can be closed in a number of ways with an absorbable stitch, surgical skin glue or Steri-strip (paper suture), generally these will be covered with a water-resistant dressing of some sort. You may shower or bathe. Avoid placing oil lotions on the glue and it will gradually peel off over time. Sometimes a swelling and/or a lump under the incision will develop and is part of the natural healing process; you need not be alarmed unless there is drainage more than a plaster will handle. Bruising may occur here too. Prior to your discharge from hospital the nurses will provide you with wound care instructions on your discharge. 

When to seek urgent help

It’s totally usual in the first weeks after surgery to experience all sorts of symptoms. Many people think their reflux has returned, they can get chest pain and even oesophageal spasm mimicking cardiac pain, hiccups and repeated burping, odynophagia (pain when swallowing) and throat symptoms including those mimicking LPR. These are all quite normal and should resolve so long as you continue to eat normally, however it can take 3-6 months for everything to settle down. 

However, you must contact us immediately if you have significant inability to swallow fluids or yogurt-consistency foods (see section under swallowing), fever over 38.6, continuous vomiting, unusual chest or leg pain, increasingly red or hot incisions. 


Hiccups are most often due to fluid and/or food that has not passed out of the oesophagus. Typically, they will stop in a few minutes. Wait until the hiccups have passed before resuming oral intake.


If you find that you are regurgitating saliva or liquids, this is usually due to their building up in the oesophagus. Especially saliva (foamy stuff) has a hard time being cleared by the oesophagus. Saliva and liquids tend to build up between meals and before going to bed. Taking 1-2 crackers between meals and before bed will help absorb the fluid so the oesophagus can push it through the LINX™.


Some patients experience spasm (chest tightness that can take your breath away) during the recovery period. Typically, this will last a minute or so. Spasm is most often due to food getting stuck in the lower oesophagus though sometimes will occur spontaneously. Although it can be very uncomfortable, it is not serious, and the frequency and severity will decrease as time goes by. If after 4 weeks you are having spasms every time you eat please make an appointment to see us, or at least contact our office by phone or email to let us know.

Regurgitation or heartburn

Some patients will feel heartburn symptoms after surgery. It is very unlikely this is due to reflux. Heartburn can occur with oesophageal irritation of any type including surgery – not just acid reflux. Heartburn can also occur after drinking acidic liquids (e.g., lemonade) that do not clear immediately after swallowing. Regurgitation during the recovery phase is reflux of fluid within the oesophagus, and not from the stomach. Do not be alarmed if this happens, it should resolve as the swelling goes down and swallowing improves. It is very unlikely you should need acid-suppressive reflux medications after surgery. If in the future someone wants to prescribe reflux medications for you, or you are concerned your reflux is back, please let us know. We strongly recommend a pH test to document reflux prior to starting on reflux medications, especially after surgery.

Frequently asked questions

Q: How long will the LINX™ last?
A: LINX™ has been designed to last long term. It is constructed from materials commonly used in other medical implants.

Q: Can I have an MRI after the LINX™ implantation procedure?
A:  The version of LINX™ that we currently use is considered MR conditional (safe) in magnetic resonance imaging (MRI) systems up to 1.5 Tesla. In the event an MRI above 1.5 Tesla is required, and an alternative diagnostic procedure cannot be used, the LINX™ device can be removed. You will be issued with an implant card following surgery indicating you have a magnetic implant.

Q: How long will surgery take?
A: Usually the laparoscopic “keyhole” surgery takes about 60 minutes to complete.

Q: What do I need to do after I go home?
A: When you return home:

Please resume a normal diet immediately following surgery. It is important that you eat at least three (small) meals a day. Chew food very well and eat very slowly. Some patients become constipated and need to take laxatives if their bowels have not opened. 

Q: When can I drive?
A: You may drive again when you can perform an emergency stop, but you should check with your insurance company about when you are covered to drive again. 

Q: How long do I need off work?
A: You may need two or three weeks off work depending on the nature of your job.

Q: When can I shower or bath?
A: You may bathe or shower as your wounds will be covered with small dressings (some are water resistant and the nursing staff at the hospital will be able to advise you on wound care before you leave hospital), but please avoid getting the wounds wet for approximately 48 hours after surgery. If you notice any signs of infections – high temperature, redness or swelling – please contact Mr Nick Boyle’s Team.

Q: Will I have any scars?
A: You will have four to five small 0.5-1 cm small scars on your abdomen.

Q: When can I start to exercise?
A: You can start non-strenuous activities as soon as you feel up to it after your surgery, but you should not resume lifting or strenuous exercise for at least a month.

Q: Will I set off the airport security alarms following surgery?
A: LINX™ is designed for everyday life and will not affect the airport security.

Q: Can the LINX™ device be removed?
A: Yes. You would require another laparoscopic procedure.

Q: Do I need to stay overnight?
A: If you live more than one hour away from the hospital you need to make your own provision to stay locally so that if you need to return in the event of an emergency, you are able to do so.

Q: As an asthmatic can I continue to use my inhalers?
A: We would recommend that if you usually use a powder based inhaler that you change to an aerosol one as it will be much easier to use following surgery. We have had anecdotal feedback from previous patients saying they found it difficult to breathe in sharply when using an inhaler and the longer slower breath required when using the aerosol inhaler was easier to do.