A Tough Pill to Swallow: Demonstration of Esophageal Physiologic Events Explaining Severe Dysphagia Captured on EndoFLIP After LINX Procedure

Dysphagia is a common symptom after magnetic sphincter augmentation, a minimally invasive antireflux alternative to laparoscopic Nissen fundoplication. A 69-year-old woman underwent LINX procedure in 2017 for GERD symptoms, after which she had the onset of dysphagia. EndoFLIP demonstrated narrowing and stiffness at lower volumes but acceptable distensibility at the largest balloon volume. The treatment plan aimed to improve swallowing by ingesting larger solid boluses and avoiding additional invasive procedures. This visualization of the obstruction on EndoFLIP presented a more physiologic approach to treatment with ingesting larger, rather than smaller, solid food boluses.