Dropping Acid: The Reflux Diet Cookbook & Cure (2010): What to eat and foods to avoid

by Penny Hammond on April 1, 2013 · 137 comments

in Diets

Dropping Acid - The Reflux Diet Cookbook & Cure - book by Jamie Koufman MD, Jordan Stern MD, and Marc BauerDropping Acid (2010) by Jamie Koufman MD, Jordan Stern MD, and Marc Bauer is a book that describes a diet to cure acid reflux:

  • Low fat
  • Low acid
  • Avoiding other foods that may trigger reflux
  • Foods are listed in the book – good foods in green, bad foods in red

This diet avoids discussion of sugar, refined foods, and processed foods and makes no recommendations one way or the other on them, except for suggesting people should eat whole grains.

Below is a description of the food recommendations in the diet. There’s a lot more in the book.

Use this page as a cheat sheet alongside the book. Send this page to friends, family, and anyone else who you want to understand what you’re eating on this diet.

Get a copy of Dropping Acid: The Reflux Diet Cookbook & Cure for the full details – this is an outline of the food recommendations in the book.

Also see their blog at www.refluxcookbookblog.com.

The reasoning behind Dropping Acid

The authors estimate that 100 million Americans have reflux, many of them unaware of it, and many of them incorrectly diagnosed. The incidence is on the rise, and they believe it has largely to do with excessive acid in our diets as prepared foods have been increasingly acidified to prevent bacterial growth and add shelf life. The real villain is the digestive enzyme pepsin, not acid, so an antacid won’t help many reflux symptoms. Pepsin breaks down proteins, and can only do its job when acid is around to activate it. Once a pepsin molecule is bound to, say, your throat, any dietary source of acid can reactivate it – and eat at your digestive linings.

Dropping Acid – acid reflux diet – food list

Induction  |  Maintenance  | Foods to avoid or limit

  • Eat smaller meals more frequently, instead of large meals. Avoid overeating and especially overdrinking
  • Do not eat anything 3 hours before bedtime, have a light dinner, and avoid alcohol before bedtime
  • Generally, organic is preferable
  • Average at around 10% fat content

Foods to eat in Dropping Acid – induction

Begin with 2-4 weeks on a very strict, acid-free diet – The Induction Reflex Diet. This gives the membranes lining your throat, esophagus, etc. a chance to heal

  • Eat only foods which are on the alkaline end of the scale, above pH 4
  • “If your symptoms are severe, it’s well worth considering the even stricter induction phase diet for two weeks, in which you eat nothing below pH 5″ (p.45). That means that in the maintenance list, the foods below with a star* next to them may be better avoided if you have severe symptoms.
  • Proteins
    • Eat only organic poultry and fish
    • Chicken – grilled/broiled/baked/steamed, no skin
    • Egg whites (for some people, eggs may trigger reflux)
    • Fish (including shellfish) – grilled/broiled/baked/steamed/sushi
    • Tofu
    • Turkey breast – organic, no skin
  • Carbs
    • Bagels
    • Beans – black beans, red beans, lima beans, lentils, etc.
    • Bread – whole grain, rye, unprocessed wheat
    • Muffins – non-fruit, low-fat
    • Oatmeal and all whole-grain cereals
    • Pasta – with non-acidic sauce
    • Popcorn – plain or salted, no butter
    • Rice (healthy rice is a staple during induction)
    • Whole-grain breads, crackers, and breakfast cereals
  • Low-acid fruits
    • Apples (max. 4 per week, only red apples – Fuji, Red Delicious*, Gala*)
    • Bananas (a small number of people with reflux need to avoid them)
    • Melons – cantaloupe, honeydew, watermelon (a small number of people with reflux need to avoid them)
    • Pears (max. 4 per week, only if ripe)
  • Low-acid vegetables
    • Green vegetables – excluding bell pepper
    • Fennel
    • Mushrooms – raw or cooked
    • Parsley
    • Potatoes – and all of the root vegetables except onions
    • Red bell peppers* (max. 1 per week)
    • Turnips
    • Vegetables – raw or cooked, no onion, tomato, peppers. These vegetables are mentioned in the book and in recipes: arugula, asparagus, beets, broccoli, cabbage (green, red, savoy), carrots, cauliflower, celery, corn, eggplant, endive, green beans, parsnips, peas, radish, snow peas, squash (acorn squash, butternut squash, spaghetti squash), watercress, yams, zucchini
  • Condiments and dressings
    • Vinaigrette – 1 tablespoon per day
  • Sweeteners
    • Agave nectar*
    • Artificial sweetener (max 2 teaspoons per day)
    • Caramel (less than 4 tablespoons per week)
    • Honey
  • Beverages
    • Water – non-carbonated
    • Chamomile tea (most other herbal teas are not okay)
    • Coffee (one cup per day, best with milk)
  • Other
    • Aloe vera
    • Chicken stock or bouillon
    • Ginger – ginger root, powdered or preserved – one of the best foods for reflux
    • Herbs – excluding all peppers, citrus, and mustard
    • Milk – 2% or fat-free, Lactaid lactose-free, or soy milk
    • Olive oil – 1-2 tablespoons per day
    • Soups – homemade with noodles and low-acid veggies

Foods to eat in Dropping Acid – maintenance

In the third week, go to the “maintenance” phase of the diet by choosing your foods from “good” and “bad” food lists, sticking to foods with a pH above 4.0.

The following foods are mentioned in the book, as well as the foods in the Induction diet:

  • Proteins
    • Egg whites (for some people, eggs may trigger reflux)
    • Lean preserved meats – e.g. prosciutto with the fat removed
    • Lean pork
  • Carbs
    • All-purpose flour, oat flour
    • Filo dough
    • Graham crackers
    • Pancake batter
    • Panko / bread crumbs
    • Polenta
    • Quinoa
  • Low-acid fruits
    • Raspberries*
  • Condiments and dressings
    • Italian dressing (use sparingly)
    • Hoisin sauce, plum sauce
  • Sweeteners
    • Brown sugar, maple syrup, turbinado sugar
    • Dried fruit (non-citrus), e.g dates, raisins
  •  Other
    • Baking powder, gelatin powder
    • Capers, clam juice, anchovies, olives
    • Dijon mustard
    • Fish sauce
    • Herbs – cilantro, basil, bay leaves, dill, parsley, oregano, rosemary, lemongrass, cardamon, cafir, lime leaves, tarragon, thyme
    • Lemon or lime zest (peel only)
    • Miso paste
    • Low-sodium soy sauce
    • Spices (not pepper or chili) – e.g. allspice, cardamom, cloves, juniper, nutmeg
    • Vanilla beans, vanilla extract, rose water, orange blossom water
    • Yogurt*, non-fat sour cream – 2% or fat-free
  • Fatty foods that may be used in small amounts
    • Butter, olive oil, whole egg, toasted nuts and seeds, salad dressings, citrus oils from zest (orange, lemon, lime), Italian Parmesan or Romano cheese, cheddar cheese extra sharp, blue cheeses e.g. Rocquefort

Note this is not a salt-restricted diet

Foods to avoid or limit with Dropping Acid

Notoriously bad reflux foods

  • Fatty foods
    • Deep-fried foods
    • Fatty meats – bacon, sausage, ribs, high-fat hamburgers
    • Cream sauce e.g. Alfredo
    • Butter, margarine, lard, shortening
    • High-fat nuts, including peanut butter
    • Avocados
  • Acidic foods
    • Carbonated beverages including all sodas
    • Citrus fruits/juices – lime, lemon, nectarine, grapefruit, orange
    • Alcohol – beer, liquor, and wine
    • Vinegar
  • Chocolate, especially high-fat milk chocolate
  • Caffeinated beverages – coffee, tea – limit to one cup a day, best with milk
  • Mint, especially peppermint and spearmint
  • Hot sauces and pepper (cracked black, white, or red peppers)

Idiosyncratic, usually bad foods for reflux

  • Acidic foods
    • Tomatoes, tomato sauce, tomato paste, tomato juice
    • Onions
    • Apples and applesauce
  • Garlic
  • Nuts
  • Cucumber
  • Green peppers
  • Spicy food
  • Some herbal teas (chamomile is the best tea for refluxers)

Other acidic foods that may be bad for reflux

  • Condiments and sauces
    • Barbecue sauce
    • Caesar dressing
    • Hot sauce
    • Ketchup
    • Mustard
    • Pickles
    • Ranch dressing
    • Russian dressing
    • Salsa
    • Thousand island dressing
    • Worcestershire sauce
  • Fruits
    • Blackberries
    • Blueberries
    • Cherries
    • Cranberries, cranberry juice
    • Grapes
    • Kiwi
    • Mango
    • Peaches
    • Pineapple
    • Pomegranate
    • Strawberries
  • Iced tea
  • Milk, full-fat
  • Yogurt, full-fat
  • V8 vegetable juice

Health benefits claimed in Dropping Acid

The diet in this book claims to reduce the risks for: acid reflux/GERD, atypical reflux disease, extraesophageal reflux disease, gastric reflux, heartburn, indigestion, laryngopharyngeal reflux (LPR), reflux laryngitis, silent reflux, supraesophageal reflux disease, other reflux-related symptoms and conditions:

Reflux-related symptoms and conditions (LPR and GERD):

  • Symptoms: heartburn, regurgitation, chest pain, shortness of breath, choking episodes, hoarseness, vocal fatigue, voice breaks, chronic throat clearing, excessive throat mucus, post-nasal drip, chronic cough, dysphagia, difficulty swallowing, difficulty breathing, choking episodes, globus, food getting stuck, a sensation of a lump in the throat, intermittent airway obstruction, wheezing
  • Conditions include esophagitis, dental caries and erosions, esophageal spasm, esophageal stricture, esophageal cancer, reflux laryngitis, larynx (laryngeal) cancer, endotracheal intubation injury, contact ulcers and granulomas, posterior glottis stenosis, arytenoid fixation, paroxysmal laryngospasm, globus pharyngeus, throat cancer, vocal cord dysfuntion, paradoxical vocal fold movement, vocal nodules and polyps, pachydermia laryngitis, recurrent leukoplakia, polypoid degeneration, laryngomalacia, sudden infant death syndrome SIDS, sinusitis and allergic symptoms, sleep apnea, asthma

As always, this is not intended to be a replacement for professional medical diagnosis or treatment for a medical condition. Consult your doctor before starting a new diet. This page describes what the authors of the diet recommend – Chewfo is describing the diet only, and does not endorse it.

Get a copy of Dropping Acid: The Reflux Diet Cookbook & Cure for more information on medical issues of reflux and for recipes

Buy now from Amazon
The book’s website is http://www.refluxcookbook.com, and Dr. Koufman is on Twitter at https://twitter.com/RefluxDoctor.

How has this diet helped you with acid reflux? Please add a comment below.

{ 137 comments… read them below or add one }

Warren May 7, 2013 at 9:51 pm

There are a few things I still find confusing after reading this book. What dried fruits if any are allowed and could you tell me the PH value of these. In Australia we can buy low fat ricotta and cottage cheese are these allowed. They are well less than the 10% mentioned. In the book it mentions parmesan and blue vein cheese. I would have thought they were too high in fat. Also a couple of the recipes use citrus, orange and pineapple juice. They are very acidic and this surprises me. I await your answer to my questions.

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Penny Hammond May 8, 2013 at 1:08 pm

Hi Warren,

There isn’t any clear guidance on what dried fruits are allowed. If a fresh fruit is allowed, a dried version should probably also be okay – although note that everything is more concentrated in dried fruits than fresh ones.
Some fruits trigger reflux in certain individuals and not in others, so when you’ve cleared up your symptoms you should check to see what your triggers are.
Fruits are more acidic than vegetables, so it may be better to limit them. There are lots of tables and charts online giving the pH of different foods – eg http://www.foodsafety.wisc.edu/business_food/files/Approximate_pH.pdf.

Low-fat and no-fat ricotta and cottage cheese should be fine for most people.

Certain foods are triggers in large amounts but may be okay in small amounts, “diluted” as it were with other lower-fat or lower-acid foods. These foods are: Butter, olive oil, whole egg, toasted nuts, salad dressings, toasted sesame seeds, citrus oils from zest (orange, lemon, lime), Italian Parmesan or Romano cheese, cheddar cheese extra sharp.

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Renee Little July 22, 2013 at 3:46 pm

Been diagnosed with LPR. Hoarseness and chronic cough. Ordered the book…can’t wait for it to get here. I am taking Zantac twice a day, but I want to CURE this….not just cover it up!! I am planning a complete lifestyle change.

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Penny Hammond July 22, 2013 at 7:03 pm

Great – good luck!

I used to have chronic acid reflux / GERD. First I worked out what were my trigger foods and avoided them (as well as sleeping with the head of the bed raised etc.). After a few months I was off the acid reducers (and happy because that acid is there for a reason – to kill bad stuff). Then when I felt fully healed I slowly started reintroducing my trigger foods – and because my esophagus had healed I could cope with them a lot better. After a while, there was only one food that regularly acted as a trigger – onions – and only in spring and fall (weird, huh?). Now it’s pretty rare for me to have issues – sometimes there are foods that I look at and realize that this isn’t the day to eat them, but I haven’t popped a pill for the issue in years.

Can’t promise that exactly the same will happen to you, but it’s definitely worth avoiding what’s causing the irritation and letting yourself heal. I hope it works for you.

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Thomas September 9, 2013 at 10:56 am

Hello: For years I had IBS and, briefly, colitis, but 15 yrs ago I went on the Specific Carbohydrte Diet (“Breaking the Vicious Cycle”, by Elaine Gottschall), and the problems were corrected. This diet allows very little in the way of grains. Thus my breads and muffins have been made with various nut flours. Stomach problems preceded this dietary change. Recently I read “Dropping Acid”, and am in my second week of the Induction diet. My main questions/concerns pertain to nuts, grains and canned foods. 1) MANY cannot tolerate grains, particularly wheat, and certainly not the gluten; yet this is not addressed in the book. After reading “Dropping Acid”, I wasn’t sure if I should change that, so I just made a bread out of several flours (coconut, brown rice, soy, potato, flax), reducing the almond flour from 3 cups to 1. It is delicious, but I’m wondering if any of these are not on the ‘good’ list. Also, I recently began eating wild Alaskan salmon and wild tuna. Both are organic, but are packed in a can. Would that be on the ‘bad’ list because it is canned? Thank you for your help.

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Penny Hammond September 9, 2013 at 11:26 am

If you can’t tolerate grains, then you should continue to avoid them – no need to create symptoms when trying to avoid other symptoms.

Nuts and seeds tend to be fatty, some more than others – the authors say that because fatty foods can trigger reflux, nuts are only supposed to be eaten in small amounts on this diet.
So if you’re baking bread with coconut flour, almond flour, and flax meal, you should only have a small amount. If you want to eat more, you could try other alternate flours – chestnut flour is probably the lowest-fat nut flour, or you could try a bean flour such as garbanzo flour / fava bean flour. You could try a gluten-free flour such as Bob’s Red Mill – the only grain that contains is sorghum.

According to an FDA document http://www.foodscience.caes.uga.edu/extension/documents/fdaapproximatephoffoodslacf-phs.pdf, canned salmon and canned tuna have pHs above 5, so they meet the low-acid requirements of this diet. There are canned foods in many of the recipes in this book, including canned tuna.

Hope that helps.

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Penny Hammond September 9, 2013 at 1:36 pm

Just realized that on the specific carbohydrate diet you can’t have chestnut flour, garbanzo flour or fava bean flour, or the gluten-free flour.
So that means that in your case you could only have a very small amount of the bread you made; no alternatives come to mind.
You could try eating low-nut and the rest of the recommendations in this book to give your reflux a chance to heal, then testing a higher amount of nuts to see if they’re a trigger for you.

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Roah September 11, 2013 at 11:19 pm

Hi Penny,
So, when you say an average of 10 % content, is that per meal or overall diet for the day? Also, how long did it take you to heal everything? How can you know if something is your trigger because my symptoms are nothing but constant changing to my epiglottis or mucus in the throat. I think I am night time refluxer.

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Penny Hammond September 12, 2013 at 7:59 am

Hi Roah,
You should probably have around 10% fat content per meal, rather than per day – a concentrated amount of fat can be the trigger.
It’s many years since I went through an elimination program to overcome reflux, but I remember it taking months to heal. I had a burning sensation, so it was easier for me to tell the trigger. Try getting to a baseline diet where you’re not getting any symptoms (elimination diet), then trying a food you might think is a trigger several times a day for 3 days to see whether you start getting the symptoms again (reintroduction).

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Sara September 17, 2013 at 6:41 am

HI,

I’ve been diagnosed with silent reflux 3 months ago. I was prescribed Omezaporole, which has only dampened symptoms not taken them away, which I am still on. I wasn’t given any information from the hospital about how I might have got it or how diet might help so I looked on the interenet and found ‘Dropping Acid’. I have followed the induction diet for a week and a half. The first week I really noticed a difference and even had a couple of days without any symptoms then I ate something that was too fatty and since then (4 days later) everything I seem to eat sets my symptoms off. I have really reduced the foods that are on the reduction list as they seem to set off my symptoms (feeling of something stuck in my throat, clearing of throat, croaky voice) like wheat and coffee. I am nearly at the end of my 2 week induction and am just wondering if I need to do the induction for another week or so?

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Penny Hammond September 17, 2013 at 8:31 am

Hi Sara,
The authors suggest doing the induction for 2-4 weeks to allow healing. It sounds like you could benefit from it for a little longer.

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Ro October 21, 2013 at 8:56 pm

Hi

It has been suggested to me to drink apple cider vinegar to help with silent reflux. I have read the book Dropping Acid and I thought vinegar was to be avoided. Can you clarify this?

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Penny Hammond October 22, 2013 at 7:18 am

As with any medical condition, there are a number of different opinions on which foods are beneficial and which are harmless for this condition.
The authors of this book say that although there is a claim that apple cider vinegar / ACV is good for reflux because it causes the lower esophageal sphincter to tighten up, this does not appear to be the case (p.38)

See for yourself how it affects you personally – do you notice an increase or a decrease in symptoms when you drink it regularly?

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Ro October 22, 2013 at 8:12 pm

Thank you for your response. I have not trialed the ACV until I heard back from you. I have read the book Dropping Acid several times but did not recall that section on page 38 -until you pointed it out- because until my well meaning friend suggested ACV I had no intention of ingesting any vinegars. Thank you again!

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Marilyn Stevens October 26, 2013 at 6:13 pm

Hi Penny or whoever…I have had silent reflux for years and have done quite well on 20 mg. Of Losec for several years; however, recently I went to emerged with severe pain in my back and chest and difficulty breathing. I had previously been to an ENT specialist and he put me on 80 mg. of Losec a day but I cut back to 40 after two weeks and now am having a lot of discomfort and trouble sleeping because of this awful pain (they ruled out heart problems). Do you think 80 mg. Is a little too much to be taking…the ENT wants me on it until the middle of December and the doctor in emerged told me to go back up to 80 mg. I desperately need answers as I have a lot of discomfort after eating and belching a lot as well. I wait your answer. I am going out right away to buy the book so hopefully it will help in the healing process.

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Penny Hammond October 27, 2013 at 8:00 am

Hi Marilyn. Sorry to hear about your issues; I imagine it’s a little scary to be going through this. I can’t help you with your medication questions (I look at the food side of things) but I hope you find a resolution soon.

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Marilyn Stevens October 27, 2013 at 10:47 am

On the food side, on the 2-3 week induction program, would I be allowed to have quinoa, light maz cheese, eggs, maple syrup, coconut oil and almond butter.

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Penny Hammond October 27, 2013 at 10:56 am

Quinoa – grains are allowed and it’s not a fatty food, so this should be okay
Light mac & cheese – pasta is okay, 2% or fat-free milk is okay, cheese is okay in small amounts as a flavoring – if you’re getting it in a package, check the ingredients and fat levels
Eggs – egg white only
Maple syrup – the authors don’t discuss sugars, but they’re not in the “don’t eat” category. However, for induction, you’re not supposed to have agave nectar – perhaps maple syrup would be in the same category
Coconut oil – this is a fat and the diet says keep fatty foods to a minimum
Almond butter – you can have toasted nuts in small amounts (as they’re a fatty food) so small amounts of almond butter should be okay
Overall, average around 10% fat content.

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Marilyn Stevens October 27, 2013 at 11:13 am

Thank you so much for taking the time to reply. I truly appreciated it!

Cass November 28, 2013 at 5:51 pm

Marilyn,
I just came across your posting and I too have been suffering from silent reflux for years which I have been managing quite well on this diet (I bought the book 4 years ago and changed my diet immediately and came off medication) however 5 weeks ago I started suffering from pain in my chest and back and difficultly breathing. I’ve been in A&E and had various tests run ruling out blood clots, heart etc. and I am currently waiting to see a respiratory specialist and an ENT specialist. But seeing your post has just clicked that this may be related to the reflux – none of the medical professionals had put the two together. I am feeling quite hopeful now as I was beginning to think I was imagining things and making myself ill!! I will be booking an appointment with my gastro specialist tomorrow and going back to the induction phase. Thank you!

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Marilyn Stevens October 27, 2013 at 12:26 pm

One more question Penny…may I have no-fat or low-fat yogurt during these two weeks? Thanks!

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Penny Hammond October 27, 2013 at 7:17 pm

Yogurt is one of the 3 foods you’re NOT supposed to eat on the induction but that are okay for the maintenance diet. The other two are agave nectar and bell peppers.

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Marilyn Stevens October 27, 2013 at 2:54 pm

And is the 10% content of fat for each item that I would be eating or 10% for the entire day. How much fat would be acceptable on this two week routine per day?

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Penny Hammond October 27, 2013 at 7:20 pm

It looks to me like it should be for each meal. The authors say that fat is a trigger – so if you have a fatty snack it’s likely to set you off. If that’s the case, it makes sense to spread a small amount fat across all your meals.
This isn’t a calorie controlled diet, so there aren’t guidelines on how much to eat – the total amount of fat would depend on how much you eat in total.

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Marilyn Stevens October 28, 2013 at 7:04 am

Thanks so much for your help and have a great day!

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Shayneesa November 8, 2013 at 4:29 pm

So is a grilled chicken Caesar salad good to eat & what dressings should you use

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Penny Hammond November 8, 2013 at 6:36 pm

Thinking of the ingredients of grilled chicken Caesar salad in terms of the recommendation of this diet:
– Grilled chicken should be fine; it should be skinless
– Lettuce is fine
– Croutons should be made without fat
– Dressing – that’ll be the issue. Caesar salad dressing usually consists of parmesan cheese, lemon juice, olive oil, egg, Worcestershire sauce, garlic, and black pepper. Cheese, olive oil, and egg all contain fat and should be limited. Lemon juice is listed as a notoriously bad reflux food. So look for a low-fat, low-acid dressing to use.

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Janet Walls November 16, 2013 at 1:33 pm

Outstanding

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sandra daeschler January 22, 2014 at 3:04 pm

I dont know anymore if I still have Gerd or if I now have an ulcer! However I notice when i eat a high fiber diet and alot of whipped peanut butter my stomach feels fine.How come? Thank you

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Penny Hammond January 23, 2014 at 7:54 am

Everyone’s different. There are some foods that are triggers for a lot of people, and others that are less common triggers – you have to work out what’s right for you.

You should check with your doctor to see which condition(s) you have…

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Jamie A January 23, 2014 at 7:15 pm

Hello

I am new to acid reflux/ heartburn. It started about a month ago during christmas vacation, which I’ll admit I wasn’t eating the best! I came across this list of food and I find it very helpful when choosing what to eat. I was also taking prilosec but didn’t like the feeling it was giving my stomach, so I am now trying Zantac.
My question is if I am eating this diet and taking medication will this eventually go away and I can slowly eat things that I used to eat??
I also find it strange that this happened all of a sudden that I can’t eat all these things without acid reflux, when I used to be able to have any amount of coffee and spicy food! Or is this normal?
I know this is not a medical website, sorry for the long note, just wondering about your opinion

Thank You!!

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Penny Hammond January 23, 2014 at 7:30 pm

Hi Jamie,
I had a similar personal experience – it’s as though you’ve got an injury in your esophagus, and the foods you’re eating keep re-opening the scab. The first step is to work out what irritates you, your trigger foods, eating habits, and lifestyle issues for acid reflux. For me, onions are the worst, tomatoes are not far behind; eating too much and lots of fatty foods can also set me off; and lying down after eating too much is a really bad idea for me. I found that when I avoided my trigger foods/conditions the injury eventually healed itself. When it was completely healed, I could eat the foods again. But sometimes the “scar” would threaten to open up again – I would feel a tingling in my throat when I ate my trigger foods, and know I was at risk – so I’d avoid the trigger foods/conditions for a few days to a week and then it would heal and I’d be okay to eat the trigger foods again.
Some people may have to avoid certain foods completely, others may be able to reintroduce some foods after they’ve healed.

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Jamie A January 23, 2014 at 7:48 pm

Thanks for the quick reply! I have found it has gotten somewhat better by changing my diet, so I guess as time goes on it wil heal more and more. I too found out I can not eat onions, spicy things and wine! I will definitely keep track more of what I’m eating!

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Kim January 26, 2014 at 10:51 pm

Is Yacon syrup acceptable on maintenance?

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Penny Hammond January 27, 2014 at 8:46 pm

Apparently it has a pH of 5.4 – so you shouldn’t eat it on the induction diet, although it may be okay for maintenance. Test it to see that it isn’t a trigger for you.

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Kim January 27, 2014 at 10:57 pm

Thank you so much for the quick response. I heard that agave causes some inflammation in the body so I wanted to try a new sweetener. Best regards!

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Amber February 16, 2014 at 2:25 am

Hi Penny! I just ordered this book a couple days ago. I’ve had GERD/Silent Reflux for probably about 10 months now. I always have the feeling of something stuck in my throat, and always spit phlegm/mucas. I’m excited to try this diet because I’ve been worried sick about this for months. I haven’t been eating much because of the feeling in my throat, I am always afraid I will choke on food. Because of that, I have lost A LOT of weight which isn’t healthy. With this diet I’m determined to get back on track and start eating (better), but one thing I’m worried about is medication. Will this diet alone reduce/cure my symptoms or do you need to take pills as well? I have a huge pill-phobia, I’ve never been able to take them. If I need to take pills along with the diet to get better, do you think the pills like Prilosec and similar pills will be as effective crushed/cut open as they are whole? Sorry I know you mainly focus on food but I just thought you might have an answer.

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Penny Hammond February 16, 2014 at 4:56 pm

Hi Amber!

If you have a big problem with phlegm, you could follow this diet but you may also want to try seeing whether avoiding dairy products and/or grains can help you – these are often considered to be phlegm-causing foods, especially milk products. Try avoiding them as well as following this diet to see whether you improve; if you improve try slowly re-introducing them one at a time to see how you react to them. It’s good to know your personal triggers and not just avoid all foods that are possible triggers, which may make your diet too restricted.

To help reduce your fear of choking, chew your food really well so it’s basically a thick liquid by the time you swallow it. Don’t eat while distracted (e.g. while watching TV). If you’re super-concerned about swallowing, see the Easy-to-Swallow, Easy-to-Chew Cookbook for tips on making sure your foods won’t cause you swallowing difficulties – the aim should be to make sure you can eat enough to get nutrients and maintain a healthy weight while you work out which foods cause you problems, then to eat a more normal diet that avoids trigger foods.

Hopefully you’ll be able to find your trigger foods and won’t need to take pills any more. In the meantime, check the guidelines for medications – Prilosec specifically says it shouldn’t be crushed or chewed.

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Kathy February 16, 2014 at 5:05 pm

I completed the induction diet exactly by the book for 2 wks. Most of my symptoms are getting better but I still am coughing more then I would hope to at week three. Does the coughing take awhile to get better? I am also doing a tsp of manuka honey daily … Also can I roast veggies and add a white onion during roasting but remove it after and not eat any of the onion? Thanks…Kathy

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Penny Hammond February 16, 2014 at 6:01 pm

The coughing can take a while to get better according to Dr. Kaufman’s new book, The Chronic Cough Enigma.
By adding an onion to your roast veggies, there’s probably something from the onion that’s causing the veggies to have some onion flavor – you could try using herbs or another flavoring instead. It’s possible that onions aren’t a trigger food for you, but it’s a very common trigger and worth avoiding to see if it helps.

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PJ February 17, 2014 at 11:27 am

Was diagnosed with LPR in February. Bought “Dropping the Acid”, but didn’t realize I needed to stop yogurt altogether. Have been eating all organic, low-acid foods since January, with minimal improvement. I will stop the yogurt for a couple weeks and see if that helps. I also drink a lot of soy milk. Is there any issues with soy?

Thanks!

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Penny Hammond February 17, 2014 at 7:27 pm

Soy milk is allowed on this diet. There are also recipes in the book with soy sauce and edamame.

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robin March 4, 2014 at 9:22 pm

Hi Penny,
I was diagnosed with mild acid reflux several yrs. ago and have been managing it with a whole food diet, organic-non GMO etc.I’m a big foodie, love spending hours in my kitchen,cooking all sorts of wonderful dishes. We juice a lot as a
family and I also use my vita mix,lots of green veggies, kale,parsley,cucumbers,avacados, fresh ginger, lemons or limes. I’m frustrated and so confused, because I was also told that all of these foods are very alkaline and healing! When i juice or vitamix the above, I still notice the slight burning in my throat. Could it be the lemon, lime, cucumber and avacados? After learning about the Kaufman induction diet, I was puzzled and again confused, can you please help and clarify for me. I also soak and slow roast my own nuts, Is this ok? please help and offer insight for me. Thanks so very much.
Robin

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Penny Hammond March 5, 2014 at 8:56 am

Hi Robin,
Different people have different trigger foods which set off acid reflux for them, although there are some that are common triggers such as tomatoes, onions, and citrus fruits. Some people need to avoid their trigger foods all the time, and others may be able to eat them (at least occasionally) after their body has healed. These may be perfectly healthy foods for most people, but if they cause a problem for you personally that’s going to override the “most people” as you’re eating for yourself.
The citrus fruits in your smoothies may cause you issues, and if you have a lot of fat (which might include significant amounts of avocados and/or nuts) that could possibly be an trigger for you. Cucumbers will be fine for most people with acid reflux.
Go on the induction diet to heal, and then reintroduce foods one at a time to see what are your personal triggers.
Penny

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Lisa March 10, 2014 at 9:29 pm

Thanks for all the information, I found out I have Silent Reflex, I never heard of it and thought the doctor was nuts..
Still having a hard time on what to eat that has all these acids in it… I love favored water and know I read that I can’t have that! I have always been a hard body, work out and so what is with this? lol Thanks and have a blessed day! :)

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Erika March 11, 2014 at 1:18 pm

Hi penny,

Try making gluten free bread out of corn and lentil flour it’s amazing! Anyone know why butternut squash isn’t on there? I’ve been eating it :$ hope it’s ok

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Penny Hammond March 11, 2014 at 5:51 pm

You’re right, it’s in one of the recipes although it’s wasn’t in the overall list in the book – I’ve added it above.

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Terri March 20, 2014 at 6:01 pm

This list of foods is so different depending where you look online. I have a hard time believing many of the items on it.

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Penny Hammond March 23, 2014 at 2:49 pm

I think that different people have different trigger foods – it’s worth experimenting with the alternate suggestions to see which ones work for you personally.

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Judith April 1, 2014 at 1:21 pm

Hello. I was diagnosed with Barrets in February (no dysplasia), and plan on buying the book. My question: can I drink decaf green tea? I’ve also heard good things about Manuka honey – and Aloe Vera Juice, but the brand I looked at at citric acid in it (as a ph stabalizer) – what does that mean? I have cut out all coffee, alcohol, chocolate, high acid/fat foods and peppermint. Can I eat a red apple with my toast in the morning? And can I eat pinto or garbanzo beans with my green salads? I am very dedicated and committed to making the necessary changes (I am also on Prilosec 2x day). I’m hoping this book will help. Thank you for your help and assistance.

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Penny Hammond April 6, 2014 at 3:00 pm

Hello Judith,

The book advises you to avoid caffeine because it’s a very common trigger food, and green tea contains caffeine (even if it’s less than black tea). The authors suggest you limit to one cup a day, and that it’s best with milk.

Manuka honey isn’t mentioned in the book.

Citric acid is often used as a stabilizer to stop foods from decomposing. Aloe vera juice is mentioned in the book as a healing agent that the authors use in recipes; they refer on page 50 to a blog post about it on their website but it appears to have been removed. You could use a pH tester to test the pH of the store-bought aloe vera juice; alternatively try finding fresh aloe vera leaves (you can often find them in hispanic stores) and juicing them yourself.

Apples are a food that are often a trigger for reflux. So they might be okay for you, or they might not. Try avoiding them until you’ve healed, and reintroduce them to test your reaction to them.

Beans are listed as okay to eat – there are a number of recipes with garbanzo beans/chickpeas; pinto beans aren’t mentioned but as beans in general can be eaten these should be fine.

Hope that helps!

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Dee April 1, 2014 at 9:34 pm

I have had severe GERD for 13 years, it has gotten worse over the last year. I am on Aciphex and over-the-counter GERD meds at night, abuterol and a steroid and still had difficulty day to day. I had cardio tests and its definitely GERD with asthma problems. I bought “Dropping Acid” about a month ago and it honestly saved my life! The acid foods list are very helpful. I switched out pickles for cucumbers, use non-fat mayo and low-fat dressings. I had never stopped drinking decaf coffee this whole time, once I cut back to one cup of regular decaf a day and stopped with tomato and vinegar products everything greatly improved. You can make low-acid coffee at home yourself (search for this online), easy to do with a French Press. This way along with the herbal tea I can have a second cup of low-acid coffee a day with no problems. I had quite a bit of back pain and chest tightness from GERD, all better because of following the book guidelines. I found that using a heating pad on my chest or back helped relieve and loosen up the gunk in my lungs and decreased the pressure in my back and chest. As someone who was at the end of my rope dealing with severe complications of this disease I highly recommend this book for any GERD sufferer.

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Alex April 6, 2014 at 1:08 am

I am struggling with motivation and discipline. my LPR is worsening. I can’t sing at all, my throat hurts and u cough. I think I need standard induction meals: oatmeal for breakfast ? lunch – gotta be fast and easy – maybe a tuna sandwich with like 1/8th tablespoon mayo? dinner salad with what dressing? and like a tofu dog? poach the fish? so to avoid fat? someone scare me into giving up flavor and enjoying food for a longer life where I can sing again? just in the car and shower fun singing. you don’t know how much of your soul is lost when you can’t sing with the radio, your kids or the campfire. thank you.

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Penny Hammond April 6, 2014 at 3:38 pm

Sorry to hear that.
The book has a lot of recipes, but doesn’t help you with quick and easy sandwich recipes. How about a sandwich made with chicken or other protein and salad or leftover roast veggies, or a soup as an alternative to a sandwich. There are a few salad dressing recipes in the book – they tend to have oil but limited amounts. Poached fish should be fine, or any broiled protein. Look for casserole recipes, maybe something you can put in a slow cooker if you have one – when you’re cooking with liquids you don’t need to add fats. Cook in bulk when you have time, and freeze in portion sizes for easy access. Go heavy with herbs for flavor, and try out spices as well (except chili and anything else listed as a food to avoid).

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Carol Cohen April 6, 2014 at 4:28 pm

I just bought “Dropping Acid ” and am anxious to begin the two week elimination diet. Being highly lactose intolerant, I have been drinking almond milk. Am I to understand that all nuts are to be avoided or are some less
acidic and harmful than others?

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Penny Hammond April 6, 2014 at 4:53 pm

I think the issue with nuts is the fat, not acid. High-fat nuts are the most common triggers, including peanut butter.
You can have toasted nuts in “small amounts”, although how much that is is not defined.
Almonds are fairly fatty; chestnuts are the least fatty nut but they’re not usually used to make milks.
You could try rice milk or soy milk, or possibly hemp milk although that may be slightly higher fat because it’s from a seed.

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RG April 26, 2014 at 11:29 pm

Penny,

I am glad that I happened upon your website! My questions need answers!

I am a professional who works long hours, so don’t have a lot of time to prepare foods. I have osteopenia, so need about 1500 mgs of calcium daily. I find it difficult to consume enough food to gain weight.

In addition, I have tried many medications with no relief, including Nexium. I also have lactose intolerance.

What recommendations and resources do you have for me?

I greatly appreciate your help. I am not sure what reflux medical professionals to trust who take this attitude toward healing and maintaining without drugs.

Thank you again,

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Penny Hammond April 27, 2014 at 1:06 pm

RG,

Although there are common triggers for reflux, everyone is different and you need to find out what triggers it for you. You could try the recommendations from this diet, and if that helps get rid of your reflux symptoms, introduce foods back one at a time to see which ones give you reflux. Also, look for other lifestyle factors – e.g. avoid tight-fitting clothes, don’t smoke, limit or avoid alcohol, eat smaller meals (sounds like that one might be tough for you), reduce stress (ditto), don’t eat or drink for at least 2-3 hours before going to bed or lying down, and tip your bed so the head is higher than the feet.

You mention that you have ostopenia and also lactose intolerance. There are non-dairy foods that contain calcium, the most efficient being canned fish with bones, such as sardines or salmon, and eating the bones. Some dairy substitutes are fortified with calcium, such as almond milk and other nut and bean milks. Also, there are many people who believe that if you reduce processed foods / animal foods and eat more plant foods your calcium balance will improve – see these posts by Dr. Joel Fuhrman and Ostopenia3.

Unless you have really severe lactose intolerance, you should be able to have some dairy foods. Lactose can be “pre-digested” and broken down into digestible sugars for you in two ways: by certain fermenting processes and by adding lactase. Traditionally made yogurts (with live active cultures) and hard cheeses tend to be very low in lactose because the fermentation process “eats” the lactose for you and breaks it down. Also, products such as Lactaid brand (milks, ice creams, etc) have already had the lactose removed, and you can get lactase drops to add to milk or lactase pills to take before eating lactose-containing dairy foods – these are substitutes for the lactase that isn’t being produced by your body.

Hope that helps.

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RG May 3, 2014 at 1:38 pm

Penny,

How I appreciate your explanations and clarifications of these dietary directives! Thank you!

1. What research-based evidence supports Dr. Koufman’s diet over others? What does the medical community think?
2. What simple recipes and menus can be used by people with little preparation time?

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Penny Hammond May 4, 2014 at 8:01 pm

There’s a section at the back of the book called “Reflux Science You Can Digest), which contains a history of medical opinion on various forms of reflux disease, differences between different types of reflux, causes of reflux, reflux and cancer, and dietary and regulatory changes which have increased reflux. It contains a number of references to research.
In most areas of medicine, opinions differ. What probably matters the most is whether this diet works for you, personally.

The recipes in this book are written by a chef and many of them aren’t designed for quick preparation.
There are a number of books for low-acid cooking; watch out as there are a few different definitions of “low acid” – books which are aiming for an “alkaline diet” are vegetable-based and many consider citrus fruits to cause low acid in the body; that’s not going to help your reflux.
You could try using recipe books like Eating for Acid Reflux and The Acid Reflux Solution, or look for low-fat recipes and watch out for ingredients that are triggers for you.

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Ella May May 1, 2014 at 12:25 pm

The book plainly states that agave is permitted on the induction diet. It’s the first item listed of allowed foods, in fact. So not sure where the advice above to avoid it is coming from.

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Penny Hammond May 1, 2014 at 6:49 pm

Thanks for pointing that out.
If you have severe reflux, the authors advise that you don’t eat anything below pH 5.0. And on page 64 they list agave nectar as having a pH of 4.5, which is below 5.0.

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Ella May May 2, 2014 at 10:05 am

That’s an excellent point, but regardless I would not state that agave is not permitted on the induction diet since she specifically states that it is. She also permits 4 red apples a week on that diet, and all of the red apples listed on page 63 are between 4.0 and 4.2 pH. Her statement on page 61 that the induction diet “means eat nothing below pH 5″ is clearly imprecise — but perhaps she allows some latitude depending on the type of food (and perhaps neglected to note that on page 61). There are other discrepancies in the book as well, such as that cucumbers are permitted on the induction diet. However, those are listed on page 59 as an “idiosyncratic” food. I can forgive these minor transgressions, however, because this diet (along with acid blocking meds) has been the only thing that has ever made a dent in my chronic cough of nearly 30 years! In any event, your website is a useful resource. Your summaries of these myriad diet books are helpful and informative. Keep up the good work!

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Ella May May 2, 2014 at 10:40 am

Forgot to add one point — the book states on p. 45, “During induction, you eat 3-5 meals per day of ONLY the best foods LISTED BELOW” (emphasis mine). Thus, any advice above stating that during the induction phase people can eat egg whites, cheese as a flavoring, almond butter, etc. directly conflicts with that statement since none of those foods are listed in the “best foods” list on page 46 of the book. That’s not to say that people might be able to “get away with” eating those things anyway; however, they do so at their own risk. In my own experience with the induction diet, I followed it to the letter for two weeks. It’s extremely strict (and about as boring as it gets). But it worked for me!

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Penny Hammond May 4, 2014 at 8:06 pm

Thank you so much for your detailed feedback. I went back and reviewed the book and re-wrote much of the post.

When writing up diet books I usually include ingredients from the recipes; in this book, there are recipes containing tomatoes, garlic, cucumber, lemon slices… which you may not have expected to see in recipes as they are listed as often or sometimes bad for reflux. I left these in the red “avoid or limit” section.

RG May 3, 2014 at 1:31 pm

Dr. Koufman addressed dried fruit on her blog, http://www.refluxcookbookblog.com/2010/03/17/some-advice-on-dried-fruit/
” In addition to dried apricots, dried Fuji apple, pear, and banana are fine on the reflux diet.”

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RG May 3, 2014 at 1:44 pm

There is also an article, “It’s Manuka, Honey!”
http://www.refluxcookbookblog.com/2011/06/02/manuka-honey/

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susan martin May 5, 2014 at 4:44 am

Hi I have a hiatus henea with a lot of pain like having a heart attack, it needs surgery but due to other illnesses they will not chance it, will this book be helpful for me there are a lot of foods I have to avoid now.
Any help I would be so grateful.

Susan martin

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Penny Hammond May 6, 2014 at 2:25 pm

Here’s what the authors say about hiatus hernias: “people can have reflux without a hiatal hernia, and people can have a hiatal hernia without having reflux. What is true is that many people with reflux do have such a hernia, which implies a relatively weak lower esophageal valve” (p.161)
So it’s possible that the dietary recommendations in this book would be helpful to you, but it’s possible that they might not. Give it a try to see if it helps you.

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Sue May 12, 2014 at 12:53 pm

Hi: My question is about sauerkraut – is this allowed on the induction phase and how about after the
2-4 weeks. I want to get started right away and not wait for my book to arrive and this is something that I eat
every day. I have suffered terribly for the past four years and am so excited to find this website and book.
Also, my calcium/magnesium liquid supplement contains citric acid (and yes it burns on the way down). Should
I switch to a tablet instead in your opinion.

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Penny Hammond May 13, 2014 at 7:55 pm

Sauerkraut isn’t listed in the book, so we should check what is the pH. I found this article saying that safe sauerkraut has a pH of 4.0 or less to make sure it’s properly preserved – that would be too acidic either for the induction diet or the maintenance phase. As with everything else, it’s may be worth avoiding during induction then testing later to see you you personally react.

I look at the food side of diets, not supplements, but it sounds like you may want to switch to another form if what you currently take is burning you.

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Diana C May 27, 2014 at 6:48 pm

Hi Penny,
I’ve had problems sleeping because of acid coming up into my mouth when sleeping. Usually it leaves a bad taste in my mouth, but for the past 5 months has gotten worse, waking me up during the night with a parched throat and mouth. I noticed it really got worse when I had thick tomato soup 5 months ago and its been a little better since I stopped drinking any sodas, eating tomato products, acidic fruits, wine and eating before 5pm. Even when I stop eating a light meal at 4pm , I still wake up every few hours with acid. Is this considered “Silent’ Acid Reflux?

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Penny Hammond May 29, 2014 at 6:13 pm

Hi Diana,
The book says that Dr. Jamie Koufman (one of the authors) came up with the term “silent reflux” to describe a type of reflux without indigestion and heartburn (a painful burning feeling just below or behind the breastbone). So if you’re not getting those other symptoms, you could describe it as silent reflux.

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Shanthini Perera May 28, 2014 at 4:56 am

I have been diaganosed with Barrett Esaphagus .
I want to get this book but not available in australia
any advise?
thanks
shanthini

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Penny Hammond May 29, 2014 at 6:16 pm

The book advises that they “believe that for patients with Barrett’s Esophagus (a form of esophageal pre-cancer attributed to reflux), intense, long-term medical treatment should be combined with a long-term acid -free diet (nothing below pH 6). We have shown that pepsin is found in Barrett’s biopsies, and the best treatment regimen might deactivate it.”

If you want, you can buy the book from Amazon USA and get it shipped to Australia – http://www.amazon.com/gp/help/customer/display.html?nodeId=596190

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Darlene Peterson June 17, 2014 at 9:09 am

I just ordered the book and it seems to be very thorough but I would have liked to see a weekly menu for the induction phase. So much easier for me than to plan one myself. I started feeling chest pains within the last 6 months but I suspect I’ve had symptons for quite some time. I also have gallstones, so my goal is to figure out which of the problems is really causing the chest pains. It may actually be both. I’ve been cutting out the fatty foods but I didn’t realize I was still eating a lot of foods that impacted my reflux.

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Penny Hammond June 19, 2014 at 5:27 am

Good luck!

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Gabby June 28, 2014 at 11:52 pm

Hi Penny,
I find the book very helpful – can you recommend a doctor for Gerd/LPR in the Philippines or Singapore who has worked with you or Dr. Jamie Koufman? I find it very difficult flying to the States to get proper treatment.

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Penny Hammond June 29, 2014 at 11:03 am

Hi Gabby,
Try contacting the authors directly to see if they know any experts in your area – http://www.refluxcookbook.com/contact.

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shanelle July 1, 2014 at 3:06 am

Hi, I am 17 yrs old and suffering from heartburn, tight throat and tight chest, is it acid reflux? I am very worried as I dont know if anyone my age faces the same thing. I tend to feel the reflux and tightness in the chest everyday, after eating and even when I’m not eating. It seems to be there the whole day.. I hope to concentrate on my studies but I cant seem to. What else can I do besides change in diets, to reduce these symptoms when im not eating? Thank you!!

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Penny Hammond July 1, 2014 at 5:40 pm

Hi. It’s possible you’re suffering from acid reflux, although you should check with your doctor in case it’s something else.

As well as avoiding food triggers, you can try other recommendations for avoiding acid reflux – there’s a pretty standard list at http://www.webmd.com/heartburn-gerd/america-asks-9/nighttime-heartburn-sleep-tips – sleep on your left side with your body elevated; lose weight even if just a little; wear loose-fitting clothes; don’t eat late at night and avoid large meals; relax when you eat; stay upright after eating; wait a couple hours after eating to exercise; chew gum; quit smoking; check to see if any medications you take could cause heartburn.

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shanelle July 2, 2014 at 5:06 am

Hi, the doctor prescribed me with nexium, 20mg tablet 2 times a week. Is it necessary to use such strong medicine and will it be safe for teens to use? Or should I reduce to 1 tablet each day?:/ Is there bad side effects? Thank you for your time to answer my many questions!

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Penny Hammond July 2, 2014 at 1:53 pm

I focus on the food side of diets, not medications, so I’m not an expert here.

The Nexium prescribing information is at http://www1.astrazeneca-us.com/pi/Nexium.pdf#page=1. In section 2, dosage and administration, it gives dosage for pediatric GERD (12-17 years) as 20 mg or 40 mg once daily for 4-8 weeks for healing of erosive esophagitis, and 20 mg once daily for 4 weeks for symptomatic GERD. Side effects listed for teens are headache, diarrhea, abdominal pain, nausea, and somnolence (<= 2% incidence, which means they don’t happen very often).

If you’re uncomfortable with taking medications, you could try using food and other non-medication methods to see if they work for you.
For some people, it’s good to have a kickstart to heal the esophagus (short-term use only), and medications may help with that.

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shanelle July 2, 2014 at 10:16 pm

Thank you for your reply! I am trying the induction diet now, but might need a little help in planning my diet. Can i get an opinion from you regarding my food diet?:) : breakfast- wholemeal bread, Lunch-fishball noodles soup./fish porridge/mushroom fish soup noodles. Snack-tuna(?) Sandwich/wholemeal bread. Fruits:honeydew/pears/watermelon/bananas. Dinner: homecooked vegetable+carrots rice/soup noodles. [Small portions]. I can feel the acid in my throat and thus keep swallowing saliva with bubble/air which made me more uncomfortable. Is is better to drink one full cup of water every hour or so, or sips? My reflux is the worst during night time right before bed, though i eat 4 hours before bed. This caused me to have difficulty sleeping. I tried elevating my bed and sleeping on my right side as well, but the symptoms seem to stay. What can i do? Thank you so much for your help!

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Penny Hammond July 3, 2014 at 12:02 pm

Your meal plan sounds like it would fit within the guidelines in this book. Watch out for onion, tomato, and other foods that may be triggers, listed in the “Foods to Limit or Avoid” section above. And to start off with, it might be a good idea to avoid honeydew and watermelon as they’re triggers for some people. Try to get some variety in what you eat.
Drinking a cup of water every hour in sips sounds like a good idea. Try to not have anything to drink 1/2 hour before or after eating, to see if that helps. Also try not drinking anything for several hours before you go to bed.
It sounds like you might be getting stressed because you’re expecting to have reflux when you go to bed – see if you can find a way to relax and take your mind off things before you go to bed.

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shanelle July 3, 2014 at 11:06 pm

Thank you for taking the time to reply, really appreciated your help:) weirdly, my reflux seem to start before food too and seem to stay for the whole day:/ but before my gastro appointment in Aug, I will try this diet and hope it will help me heal gradually:) thank you once again!

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Ann July 6, 2014 at 1:47 pm

Hi all. I am new to the sight and to lpr. I got diagnosed in January . I also have a hiatal hernia. I have been on 40mg of protonix 2x a day. I started to feel joint pain and asked my doctor to drop me to 1x a day which he did. I do feel better but know I need to be careful of the foods I eat to really kick this. I read “Dropping Acid” and have made many dietary changes. There are just a few thing that I always question about if they are good for me. I love smoothies and have been trying to figure out which liquids are best. I am currently trying coconut water, soy milk and almond milk. If you could please let me know which would be the best for the silent reflux. They all pretty much feel the same when I drink them. Also, I love to bake and was wondering if millet flour is okay? I also love chocolate and wonder if I was going to eat any would really dark or white chocolate be best? I apologize for all the questions but this is my first blog and have tons of questions. Thank you for all of the other posts because they do. Help answer a lot of them.

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Penny Hammond July 6, 2014 at 3:54 pm

Liquid for smoothies – a few different coconut waters were tested by the authors; if you’re having coconut water, look for brands with no acid added; there’s a list of acceptable brands and their pHs.
The book lists soy milk as okay to eat, including the induction diet.
The book doesn’t say anything about almond milk – I haven’t found a definitive pH, but it looks like it’s slightly alkaline and okay to eat.

Millet flour – I also can’t find a definitive answer about the pH of millet, but several websites refer to it being alkaline. There aren’t any grains listed in the book as being trigger foods. Perhaps you could have millet and millet flour on the maintenance diet.

Chocolate is a well-known trigger for reflux, so you should definitely test it to see how you react to it. The authors say that high-fat milk chocolates are a stronger trigger, so dark chocolate would be best (if you can tolerate it). It’s probably worth waiting until you fully heal before you add it to your diet regularly.

Good luck!

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Ann July 6, 2014 at 7:14 pm

Thank you so much Penny! I checked out the list. It is very helpful. This has been so hard because I love healthy foods but so many are on the no lists. I used to put PB2 which is a dehydrated peanut butter powder with no fat in my smoothies. I have been so afraid to try it again. What is your opinion considering the fat is removed? Also, I know this may be a long shot, but I found a pure cocoa powder with no caffeine and no fat. Do you think that would be the best option when I am healed or should I stick to white chocolate if I am desperate? Also, I love beer but all carbonation bothered me. I have been drinking very low carbonated beers like guiness. Do you think that is less damaging? Sorry for all the questions. I am such a foodie that this is so hard.

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Penny Hammond July 7, 2014 at 11:17 am

Hi Ann,
The time for testing foods is when you’ve healed and aren’t getting symptoms – at that point you’ll be able to feel whether a particular food is a trigger for you or not.
The book says that fatty foods are a trigger – it doesn’t say peanuts are a trigger, it says the fat in them is a trigger. So a fat-free version may be less likely to be a trigger.
Cocoa itself can be a trigger food, whether it has fat or not – you should see how you personally react to it. White chocolate doesn’t actually contain any cocoa powder, but it’s fatty in itself can be a trigger – the book says that dark chocolate is less of a trigger than high-fat milk chocolates, so white chocolate is more likely to set off your reflux than dark chocolate.
Carbonation is a well-known trigger; carbonated drinks are some of the most high-acid foods around. Alcohol in general is also a notoriously bad reflux food. Better to avoid anything carbonated or alcoholic during the healing period, then work out whether you have any tolerance for them by testing to see your reaction.

Concentrate on healing first. Then test different foods to see how you react to them. You may find that many of the foods which are common triggers aren’t a problem for you, and you can introduce them back into your regular diet. There may be some other foods that are triggers for you that you can cope with in small amounts or occasionally.

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Ann July 9, 2014 at 6:54 pm

Thank you Penny. I appreciate all of your time and advice. I totally understand to be careful until after healed. I was wondering what is your opinion on whey isolate vanilla protein powder with stevia in a smoothie? I make sure I have lots of raw baby spinach, soy or almond milk and a banana. I also love to bake, would you be able to recommend the best thing to use as the fat in the cookie. I was using only a little coconut oil but I am not sure if it is the best choice. I have another upper endoscopy this Friday so I guess I will see if the meds and my dietary changes are working! Thank you!

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Penny Hammond July 10, 2014 at 5:48 pm

Whey isolate protein powder has a low fat content (check it!) and low-fat milk products are allowed on the diet, so it looks like it fits within the authors’ guidelines.

Try out of the box solutions for replacing fat in baking – e.g. using pumpkin puree or grated zucchini. There are a lot of low-fat diets from years past with baking recipes!

Good luck with the endoscopy. If you’ve only started the diet recently, you might not see much change – it takes a bit of time for the effects to work.

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Emily Ambrose July 13, 2014 at 5:52 am

Hello, am new here as well and recently diagnosed with gerd and esophagitis, and now have a big headache over my diet. I’m trying to figure out what works best for me but all food I eat seem to trigger my reflux as I feel something moving all the way up to my throat,and occasionally feel the pain in the area just below my chest. However, I don’t see anything I eat at the ‘food to avoid section’. Are whole-wheat bread and crackers a form of trigger for some people as well? As I eat them every morning, together with cut papaya fruit. What is your opinion on baked muffins(maybe banana muffin) or plain waffle/pancakes? As I have a sweet tooth[haha I know I have to avoid all sugary stuffs now] but how about adding a little kaya over my sandwich or waffle? Also, for lunch and dinner I always eat all fish as I think fish is the best form of protein: fishball noodles soup or fish soup or rice with fish, vegetables and tofu. Oh, and I eat pandan soft sponge cake and fruits like pears and apples too. For drinks, it’s just water and soy milk occasionally. All my diets are plain so I don’t know what is the trigger for my reflux:/ I feel it’s really hard to manage acid reflux, any other tips on how you finally managed to overcome this? How long did you take?

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Penny Hammond July 13, 2014 at 8:48 am

I’ve never heard of whole-wheat bread, crackers, or any other grain-based food being a trigger.
However, if you eat a lot of them, the fullness could trigger reflux. Are you eating a lot at each meal; if you eat smaller amounts / graze through the day does that help?
Also, watch out for the fat level in sweeter carbohydrate foods such as muffins, waffles, and pancakes.

There’s nothing in the book to say you can’t have sugar, kaya, or any other sweetener.

Keep an eye on the amount of apples and pears you eat (the book says max 4 per week), and look for lower-acid varieties.
I can’t find anything on the acidity of pandan juice, used to make pandan sponge cake – if it’s not acidic, and if there isn’t much fat in the sponge cake, it shouldn’t be an issue (unless it’s a personal trigger for you)

Did your doctor prescribe an acid reducer or another drug to help heal the acid reflux? If you have bad reflux that could help to reduce the “acid burns” on the damaged area in your esophagus and give it a chance to heal (only use for a relatively short time – see the guidelines on the prescription or medicine guidelines).

For me personally, it’s many years since I cured my reflux, but I remember it taking a while – at least several weeks, maybe a few months.

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Emily Ambrose July 14, 2014 at 7:30 am

I did start to cut down the size of my meals since I was diagnosed, the most 2 slices of wholemeal bread and a few cut pieces of papaya. I’ve heard papaya aids in digestion so I’ve been eating a lot of that, however, this is not in the low acid fruit list for induction diet, what is your opinion? There are not many low-acid food though so I have a tough time deciding what to buy when I eat out too, mostly choosing fish soup noodles. Too much fish in the diet is slightly acidic too right? I’m not sure what other varieties of food there are besides fish tofu and chicken, and have been only eating them all day.
Yes, I’m prescribed with raprazole and domperidone, but they seem not to help much though. Thus I try to be picky over food and am at a loss everyday trying to choose what I can eat.. If my current diet is okay, I will try to follow it through and see if my condition improves. *pray*

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Penny Hammond July 14, 2014 at 10:32 am

The book doesn’t mention papaya, but I’ve seen it mentioned in other places as useful for reflux. However, everyone’s different – you could try cutting out papaya for a few days (while eating smaller portions) to see if it makes any difference.

Be careful when doing online searches for acidic foods – there’s a theory that animal foods are “acidic” or “acidifying” for the body and vegetable foods are “alkaline” or “alkalizing” – this isn’t the same as the pH. According to that theory, lemons and limes are alkalizing – but they’re definitely an acidic pH. The book asks you to avoid fatty animal meats because the fat level can be a trigger, but doesn’t consider fish, poultry, or meat in itself to be acidic as it doesn’t have an acidic pH.

Follow the other non-food guidelines for reflux (no tight clothing, don’t eat before exercising or going to sleep, etc.), and see if you can find any relaxation techniques that help you be less stressed about the reflux as that in itself may be a trigger.

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Jen July 20, 2014 at 2:10 pm

Just ordered the book and waiting arrival. On reading the reviews I’m a bit concerned that this book may cover LPR and not GERD as I seem to have it. I used to get severe heartburn after eating, followed by chest and back pain but recently only seem to get slight slight heartburn after eating followed by chest and back pain about an hour later. I do however sometimes have to clear my throat a lot as my voice is hoarse. I have been to doctors and now awaiting results of tests. Just wondered if this book is likely to help with my symptoms.

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Penny Hammond July 20, 2014 at 3:56 pm

This book is for GERD as well as LPR and other reflux-related conditions. See the “Health benefits claimed in Dropping Acid” section above for a full list.

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louise July 20, 2014 at 6:50 pm

hi i was wondering if its ok to drink ensure or boost .i have inactive gastritis with chronic inflammation ,hiatis hernia and silent reflux .i was reading that with silent reflux pepcin lies in your throat and can be triggered off by ascorbic acid and both drinks ensure and boost have it. thank you louise

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Penny Hammond July 21, 2014 at 10:59 am

Hi Louise,
I can’t find the pH / acid level of either drink, and there’s nothing in the book on ascorbic acid.
The authors test brands to advise what fits within the diet – see their blog http://www.refluxcookbookblog.com/. You could try to contact the authors so see whether they’ve tested those drinks and have any advice on them.
Alternatively, you could contact the manufacturers of the drinks to ask what is the pH of the drinks.

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Jen July 21, 2014 at 2:40 am

Penny, thank you for your reply. Now looking forward to receiving the book. Just one query, muffins are mention in the good food list, does this mean English muffins or the American cake type?

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louise July 21, 2014 at 12:47 pm

hi i would also like to know if cereal that has ascorbic acid in it is also bad for silent reflux. thank you so much for your help.

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Penny Hammond July 21, 2014 at 7:01 pm

Ascorbic acid is pretty commonly used in food processing as a preservative/antioxidant, and it’s related to vitamin C. If you were eating it by itself, that probably wouldn’t be a good idea. However, as a very minor ingredient in a food with a low pH/acidity, it shouldn’t be an issue.

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Janet July 27, 2014 at 10:33 am

Hi! I am so happy to have found this website. I have been suffering with acid reflux for many months. I have been trying to follow a strict diet……recently have stopped gluten and dairy. The problem is I have always been very thin, but now I am extremely thin since this acid reflux started. I have a good appetite, but the foods that would help me gain weight would bother the acid reflux. Also, I seem to have a problem with malabsorption. Can you give any feedback on what I can do about this problem? I can’t lose any more weight. Thank you so much for any help you can give me. Also, I do take certain supplements, etc. Thanks!!! I have the “Dropping Acid” book and have been reading, plus about 1oo other books on acid reflux!!!!!!!

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Penny Hammond August 4, 2014 at 6:59 pm

Hi Janet,

Stopping gluten and dairy is pretty trendy right now, and it’s a strategy that may work for some people, but that doesn’t mean that everybody should do it. If you’re following a low-fat diet like this one, you can’t be low-carb as well, as you need either one or the other (fat or carbs) to get your energy!

Step back up with the carbs, eat small portions, and chew well. Try to fix the acid reflux before fixing other less-urgent issues you have.
Try an acid reducing medicine temporarily, to help you heal.
And remember that different foods are triggers for different people – once you’ve healed, test foods to see what sets you off, and if a food doesn’t give you acid reflux you can add it back in.

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Aaron August 2, 2014 at 9:35 pm

Hey Penny,

My name is Aaron I am 26 years old an was recently diagnosed with LPR I’ve been following Dr. Kaufmans Induction Diet guidelines and had a couple of questions. The first one being, in the book it mentioned that you should follow the induction diet for two weeks until your symptoms improve, there is no doubt that my symptoms have been improving only after a week but I was wondering if it was okay to follow-through with some of the delicious recipes that are in the book on my second week? Or are these reserved for the second faze after the induction diet?

My Second question is in regards to your personal experience with LPR, it is evident reading through some of your posts that it takes a while for the larynx to heal similar to a wound. Besides the diet is there anything you would recommend to help with the healing process? How long did it take for you to get through the healing process and start to incorporate other foods into your diet?

Thanks for your help

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Penny Hammond August 4, 2014 at 8:21 pm

Hi Aaron,

Many of the recipes should be suitable for the induction diet, as well as the maintenance diet – check the ingredients if you’re not sure.

It’s many years since I healed my acid reflux, so I’m not exactly sure about the time periods!
As well as the ingredient recommendations, follow other food recommendations (such as eating small amounts and not eating for several hours before sleeping) and non-food recommendations (such as avoiding tight clothing, quitting smoking, and sleeping with the top of your bed elevated).
Use acid-reducing medications temporarily to help give your esophagus a break, if you’re comfortable with that.
When you’re not feeling symptoms any more, pick one food at a time to test (a regular portion size) to see if you can re-introduce it – if you get no symptoms it might not be a trigger food for you. For any trigger foods you identify with testing, try re-testing a few months down the line to see whether it’s still a problem for you.
In the long run, you may start to recognize the initial twinges of discomfort when you can’t eat foods that are slight triggers for you – when you get the first sign of symptoms, cut back on foods that you tested which were giving you problems previously, and let it heal completely before you start eating them again.

Hope that helps!

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Mitch August 2, 2014 at 11:47 pm

Hi Penny, I was wondering how Egg White Protein Powder would deal with silent reflux/ LPR. As of now I’m not having anything below a PH level of 5. I’m big in to lifting weights and would like to have another source of protein other than chicken and salmon. Thanks!

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Penny Hammond August 4, 2014 at 8:24 pm

Hi Mitch,
If egg whites aren’t a trigger for you, egg white protein powder may be okay for your reflux. Or you could have “real” egg whites instead, or skinless turkey breast or other fish/shellfish prepared with little/no fat.

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Mitch August 6, 2014 at 6:15 am

Yeah, I do eat a lot of real egg white, hard boiled and I put them in my smoothie. So far they don’t seem to trigger me. I also use hemp protein as well. It just takes a lot of it to get the amount of protein I need. Lately I have been way under my calorie intake then i normally was. Before I started doing this diet. I will give the egg white protein powder a try, hopefully the results are good. Thanks!

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mohamed magdy August 9, 2014 at 1:03 pm

The problem starts since 6 months i had strong coughing for 4 days continously and it was diagnosed as allergy after that i have a feeling of something stuck in my throat i went to many drs and they diagnosed as gastro osphegal reflux as i made barriam swallow x-ray and thyroid ultra sound on my throat and ct scan for chest area as i was worried to be cancer but nothing appears in any of these just reflux , the problem is i am suffering of these symptoms from six months is it takes long time to cure reflux? i took many meds as pantozol nexium and motilium but nothing changes my symptoms is pain in chest area sounds in neck and back during swallowing and feel somthing stucks in my throat can you help me?

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Penny Hammond August 10, 2014 at 10:42 am

If you are eating foods that trigger reflux, you’ll probably continue to get symptoms even if you’re taking medications. The diet in this book excludes common triggers.
Most people have reflux for many months before looking for non-drug cures for it. 6 months is not unusual. It will probably take at least a couple of weeks to a month or two to heal, after you identify and exclude your triggers.

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mohamed magdy August 10, 2014 at 11:54 am

Kindly how can identify my triggers

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mohamed magdy August 10, 2014 at 12:59 pm

I apperciate your rejoinder thanks alot.but di u think shall i worry or its normal case and just following diet will help

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Penny Hammond August 10, 2014 at 1:39 pm

I can’t tell whether it’s a normal case, you should check with your doctor.

Penny Hammond August 10, 2014 at 1:38 pm

Follow this diet until your symptoms get better. Then try reintroducing other foods one at a time to see which foods trigger your symptoms.

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mohamed magdy August 13, 2014 at 11:55 am

I have done gastro endoscopy and the dr . Informes that everything is normal and i havent to worry about but the symptoms is there i will try to follow the diet is it takes long time to heal?

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Penny Hammond August 13, 2014 at 2:07 pm

If this diet works for you, the healing won’t be immediate. As I mentioned before, it will probably take at least a couple of weeks to a month or two to heal, after you identify and exclude your triggers. This isn’t an exact science!

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Marsha Earl August 14, 2014 at 1:00 pm

I have had reflux with hiatal hernia for 20 years on and off. I have never seriously tried a diet for any length of time. I know I Must now. No doctor has ever been as specific about what to eat, either. Usually they just suggest losing weight and watch for triggers, but nothing else. I am excited about this book, have ordered it, and am waiting for its arrival.
Would like to know if onion powder and garlic powder are the same as garlic and onion and should be limited in the first couple of weeks. Should we limit salt and pepper for seasoning, too in the first couple of weeks. Thanks.

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Penny Hammond August 14, 2014 at 1:52 pm

Yes, you should avoid (not just limit) onion powder and garlic powder for the induction diet and maintenance diet.
When your symptoms subside you can test onion and garlic to see whether they’re triggers for you – if not, you should be able to add them back in.

Pepper is a notoriously bad reflux trigger, so you should avoid that as well until you test it.
This isn’t a salt-restricted diet; you can eat salt.

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Emily Ambrose August 18, 2014 at 7:56 pm

Hi I have posted before a month a ago, and have been trying the induction diet for 2 weeks and maintainance for the other 2, together with raprazole. But it seems that the reflux stays the same, and my heartburn starts 2 weeks after the medication, which seems like the medication stopped working. Should I continue the diet? How long do I need to stay on the diet for the symptoms to start getting better? Have seen a gastro doctor and he just gave me dexilant without any other suggestions and diet modification.. Besides the diet, I would like to try some natural ways to heal too. Any suggestions? I tried manuka honey 3-4 teaspoons before meals and before bed. However I read that manuka honey is acidic, is this allowed for the diet? I’m also underweight but I lost even more weight with this reflux disease since I’m eating really small portions. Is snacking on plain crackers or plain pancakes/waffles okay? How about plain tuna sushi without the wasabi/sauce? I also have constipation, what low acid food should I include in the diet? Just for reference, I eat plain bread for breakfast, tuna or chicken sandwich or fish noodles for lunch. Dinner is almost the same, rice with vege(alternating with steamed celery, spinach, broccoli, cabbage), carrots, potato. Sometimes adding lean chicken breast or salmon. I also eat a few slices of papaya before meals. Sometimes pear or honeydew. Thank you for your help!

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Penny Hammond August 19, 2014 at 5:21 pm

Sorry to hear things aren’t working out for you. After 4 weeks on the diet, I’d expect to see a bit of improvement. It’s possible you have non-food triggers, or other foods trigger the reflux.
Manuka honey isn’t mentioned in the book. If it has an acidic pH, it may be a trigger.
I don’t cover supplements, medicinal herbs, or superfoods, and I can’t help you with other natural ways to heal.
For the constipation, make sure you drink plenty of water (preferably between meals), and try increasing the amount of non-starchy vegetables you eat.

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Emily Ambrose August 23, 2014 at 1:58 am

Everything I eat seem to trigger some form of reflux, even steamed spinach and rice. Should I go for further tests and checkup? And what did you limit yourself to for every meal during your elimination diet? Could you draw out a rough meal plan for us as a form of reference?:) also for the issue on snacks, I feel hungry easily and thus snacking on various little things at one time, eg. 1-2 crackers, bread and fruits and maybe this cause my stomach to overwork? I do not know what is the cause because the reflux starts every morning once I wake up. Will schedule another appointment with the GI and may consider a ph probe test to see if my issue is caused by too much or too little acid..

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Emily Ambrose August 24, 2014 at 4:44 am

Also, do you have any suggestions what to add in my diet to gain weight? Since I am underweight and would want to regain my weight.

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Penny Hammond August 24, 2014 at 7:50 pm

This diet is a low-fat diet as fats tend to trigger reflux. To regain weight you could probably rely on carbohydrates, which are allowed on this diet.
However, it sounds like you’re having a number of issues, so you should probably check with your doctor to see whether this diet is the right one for you.

Penny Hammond August 24, 2014 at 7:22 pm

It sounds like a good idea for you to go for further tests.

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Rayca August 19, 2014 at 2:02 pm

IDK. I find it a little condescending to keep hearing that everyone is different and therefore could have different trigger foods. If that’s the case, then why the book? Either you know or you don’t. I understand to a point, don’t get me wrong. But why, for instance, would raspberries not cause reflux, but every other berry would? I mean, that just makes no sense. All berries require fairly acidic soil to absorb nutrients. And raspberries have lower acidity than some of the other berries listed as a no-no for GERD. And why the asterisk next to it. Oh yeah, you may be different and can’t tolerate them. My point is, all one really needs to do is get a list of foods and their PH balance (if you can even trust that to be correct). Then figure it out by elimination. Dr. Koufman’s diet is a pretty standard, basic, low-fat diet. I don’t see anything that I haven’t been doing for years. Having said all that, I’ve bought the book and am certainly willing to give benefit of the doubt until I read it and make a decision based on the contents, but so far, I just hear a bunch of hulla bullloo about how “everyone is different.” That’s not a good enough answer to cover contradictory advice.

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Rayca August 19, 2014 at 3:17 pm

I take everything back. I’m going to return the book and not read it. Have you seen Dr. Koufman’s brief youtube interview??? Is she transgendered? It’s the only thing I can think of. Mind you, I don’t care at all but her voice is so deep and she was “clearing her throat” during the interview. Her voice sounded raspy and again, very male gendered. Also, there is no scientific basis to believe that we can change our body’s ph balance to be anything other than neutral! Apparently, the body will leach minerals from bones, etc. after say a fast food meal to bring the body’s ph back to 7 !!! Period. That’s it. No miracle alkali is going to change that. She’s a quack!!

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James August 30, 2014 at 6:55 am

Hi Penny,

Along with Dexilant twice daily I have been precribed Gaviscon Exta (with sodium Alginate) in it 4 times daily. The Gaviscon Extra has a peppermint flavouring in it. I know that Peppermint is one of the forbidden foods so I was wondering is if this “cool mint flavouring” would be detrimental? Strangely I have noticed that a lot of the over the counter acid medicines tend to be peppermint flavoured. I am 9 days into the induction diet and I don’t want this peppermint flavouring to be negating all the effort. Any insight would be very much appreciated.

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Penny Hammond August 31, 2014 at 2:53 pm

Hi James,
You’re right, it is strange that reflux medicines are often mint flavored – I’m guessing it’s because that flavoring makes it more palatable.
The reasoning often given for mint triggering reflux is that it relaxes the nerve endings and loosens the sphincter which holds the acid down in your stomach. I don’t know what it is in mint that triggers reflux for some people – it could be the menthol in the mint, or perhaps it’s something else. Can you see what ingredient gives it the mint flavor?
Of course, mint might not affect you at all. But in case it does, perhaps you could ask your pharmacist for a non-mint-flavored version.

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James September 1, 2014 at 8:16 pm

Hi Penny,

I have checked the ingredients and all it says is “cool mint flavouring”. Unfortunately here in Hong Kong they do not have it in any other flavour. Can only hope that it is not having any damaging affect.

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Mitch September 1, 2014 at 10:33 pm

Hey, just wondering, is chicken soup okay?

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Penny Hammond September 2, 2014 at 12:10 pm

It’ll depend on the ingredients. Chicken broth should be fine. But if it has onions or tomatoes or peppers in it, you might have an issue.

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Mitch September 2, 2014 at 12:36 pm

Oh one more thing, is fish oil fine for reflex?

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Penny Hammond September 2, 2014 at 3:46 pm

This book suggests that you limit the amount of oil/fat you eat – you can 1-2 tablespoons of olive oil a day, and you could probably substitute some of that with fish oil if you want.

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Anna Budko September 13, 2014 at 10:24 pm

Hi Penny,
I am also a reflux sufferer. I have a question regarding salmon. As far as I understood, all fish can be eaten if its grilled, broiled, baked or steamed. But what about smoked salmon?
Also it says that on maintenance diet fatty foods, like whole eggs, can be eaten in small amounts. I really like eggs. So how many eggs a week would be considered a small amount for a refluxer?
Thanks, Anna

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Penny Hammond September 15, 2014 at 12:30 pm

Hi Anna,

The suggestion that fish is grilled, broiled, baked or steamed is so that you don’t use a lot of fat in the cooking process. Smoking fish doesn’t add any fat to it. And smoked foods aren’t on the list of foods to avoid as reflux triggers. So smoked salmon should be okay for most people with reflux.

The authors suggest that you average at around 10% fat content. Eggs are actually around 10% fat by weight, but that probably doesn’t mean the authors suggest you can have unlimited amounts! It looks like they suggest that you use them as a “seasoning” on less-fatty foods to add flavor, so you can mix them with veggies or other non-fatty foods to reduce the total fat content.

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