Quotations by Jamie Koufman

Reflux is not a chronic disease. If you can completely stop reflux for two weeks, the system will usually recover. Sometimes it can be done with diet alone but in many cases treatment requires medications to suppress acid or improve vagal and esophageal function. Fortunately, most airway reflux and esophageal reflux patients can become reflux free within six to twelve months. [2014] - Jamie Koufman

The only antacid I recommend with any frequency is Gaviscon. Once ingested, it forms a "raft" that helps prevent reflux by blocking the stomach valve with a thick gel. Antacids are not used as a primary treatment in patients with airway reflux. [2014] - Jamie Koufman

H2As like cimetidine (Tagamet),ranitidine (Zantac), and famotidine (Pepcid) have fewer side effects and work better than PPIs for nighttime reflux. H2As are the drugs of choice for people who need to take antireflux medicine on an as-deeded basis. [2014] - Jamie Koufman

While PPIs such as omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantaprazole (Protonix) and others may be somewhat more powerful acid suppressives than H2As, PPIs have many side effects including bloating, abdominal pain, and diarrhea, and are believed to be associated with osteoporosis (bone thinning and bone loss) and B12 deficiency. When PPIs are discontinued, many patients experience rebound, developing hyperacidity and recurrent reflux symptoms. There is reason to believe that the increasing rates of esophageal cancer may be related to the use of PPIs. [2014] - Jamie Koufman

We evaluated a natural artesian alkaline (pH 8.8) water (Evamor) in the laboratory and found that it instantaneously and permanently denatured (killed) pepsin; it also had good buffering capacity. Many of my patients report that alkaline water is a key variable in their recovery. [2014] - Jamie Koufman

Acidic foods may be combined with non-acidic foods. Acidic fruits, for example, that are not allowed by themselves, may be fine if added to breakfast cereal with high-pH milk (preferably low-fat milk) or if consumed alone with alkaline water. [2014] - Jamie Koufman

During the induction reflux diet, no eating is allowed within four hours of bed. It actually takes four hours for the stomach to empty completely. After the induction, the time between eating and recumbency (lying down) can be three hours. [2014] - Jamie Koufman

Everyone with reflux is different, and even foods that are forbidden during the induction phase may be well tolerated by some individuals, including onions, tomatoes, garlic, and peppers. These are all idiosyncratic foods; that is, some patients can tolerate one but not another, and some are better tolerated cooked than raw, such as tomatoes and onions. Some people can tolerate garlic flavorings but not garlic itself, and so on. [2014] - Jamie Koufman

When you have trouble breathing, do you have more trouble getting air in (during inspiration) or out (during expiration)? If the answer is in, it's reflux, and if the answer is out, it's asthma. [2014] - Jamie Koufman

Nocturnal (nighttime) reflux in particular can cause sinus symptoms, the most common of which is post-nasal drip. [2014] - Jamie Koufman

A pouch at the upper end of the esophagus is called a Zenker's diverticulum; and at the bottom of the esophagus, a distal esophageal diverticulum. Zenker's are far more frequently the cause of symptoms, including bringing up undigested food into the throat (especially when lying down) and chronic cough. Diagnosis is by endoscopy or barium swallow/esophagogram. [2014] - Jamie Koufman

To really ease into a good night's sleep, try a warm bath, soothing music, and chamomile tea. (Not peppermint!) [2010] - Jamie Koufman

Citrus fruits and juices are very acidic. Alcohol also causes the esophageal valves to relax and cause reflux at night. Beer and white wine are particularly bad for reflux. The best things for a refluxer to drink? Water! Certain mild herbal teas are fine (such as chamomile), along with non-acidic smoothies, or low-fat and lactose-free milk. [2010] - Jamie Koufman

About a third of reflux patients just have poor esophageal function and may need medical or surgical treatment. Another third experience relief from symptoms after trying The Reflux Diet along with medical treatment. The final third of our patients find they can achieve complete control over all symptoms just by using the diet alone. [2010] - Jamie Koufman

Theoretically, dark chocolate isn't as bad as high-fat milk chocolate, but let's face it. All chocolate is bad for reflux. [2010] - Jamie Koufman

One cup of coffee or espresso a day is fine, but people who drink coffee all day long are courting reflux if they don't have it already. We recommend switching to herbal teas such as chamomile. Green tea is okay if lightly brewed. [2010] - Jamie Koufman