Dr. Jonathan Aviv on Heartburn Causes, Acid Reflux Treatment, and a Healing Acid Reflux Diet

Dr. Jonathan Aviv on Heartburn Causes, Acid Reflux Treatment, and a Healing Acid Reflux Diet

I’m Dr. Jonathan Aviv. I’m an ear, nose and throat doctor at
a practice called ENT and Allergy Associates. I run the Voice and Swallowing
Center for the practice. I’m also a clinical professor
of Otolaryngology- Head and Neck surgery,
that’s another name for ENT at the Icahn School of
Medicine at Mt. Sinai. I’m also the author of a book
called The Acid Watcher Diet, that’s right here, a 28-Day Reflux Prevention
and Healing Program. The idea is to create a diet
that replaces medication. Initially it was thought just
for acid reflux disease. As more and more science is coming out, we’re realizing that this diet is really
an anti-inflammatory diet for everyone. Acid reflux is really
2 types of conditions. The traditional acid reflux is the sensation of
a feeling of burning starting in your stomach, climbing up into your chest. The reason it’s called a heart burn, or heart
burn is the main symptom is that the esophagus, which connects
the throat to the stomach essentially sits on the heart,
so you feel it in the mid-chest. That’s traditional gastroesophageal
reflux disease or GERD, but there’s another type of reflux. When you eat or drink something very acidic,
and we could talk about what that means, it actually causes inflammation
as you’re swallowing and not only affecting the throat, but the sinuses, the ears, the lungs and the vocal cords. This is what trips people up because they’ll come in and they’ll say,
“Oh my god, I sound like this,” and “I’ve been clearing
my throat for weeks,” and “My allergies are
acting up and I have nasal drip and I need some anti-histamines
and an allergy investigation,” when really, it’s the acidity
of what they’re eating that’s triggering all these symptoms. People say, “Oh, it’s just acid reflux. Take some medication,
take some TUMS, you’ll be fine.” As it turns out, uncontrolled or
insufficiently controlled acid reflux can lead to esophageal cancer. How could that be? Well, what happens is, when
you eat or drink acidic foods, again, whether it’s coming down this
way or things coming up this way, you irritate the esophagus. You can imagine if you’re eating
or drinking something acidic, this way or things coming up this way,
the sensitive esophageal tissues get burned, and if you keep burning them, the tissues
break down and in a certain number of cases, they transform into cancer cells. The way it was discovered is that the stomach
has a certain type of cell that produces mucus. It’s called the gland-producing cell. The esophagus doesn’t
have gland producing cells. When these cells in
the stomach start climbing up, think of it as if you’re heating
something and the fire is rising. Well, these tissues go
outside of their normal area and can become cancerous and it’s acidity that’s
responsible for a lot of this. Esophageal cancer has been the fastest growing
cancer in America and Europe since the mid-1970s. It makes you think, what
happened in the mid-1970s? Two things happened. One, the government, in an
effort to prevent food poisoning, something called Botulism, which is a food poisoning that occurs when you eat
contaminated food from a can or a bottle, they enacted a law called Title XXI. What they said is any food in a can,
bottle or box needs to be acidified. There’s a number, that
number’s around pH 4.4. As it turns out, the food packers,
in an effort to prevent food poisoning, in an effort to keep the foods on
the shelves for very long periods of time, tend to drop that number and
add ascorbic acid, citric acid, things like that to really
keep the liquids acidified. That started around the mid-70s and if you look at graphs of year
versus incidence of esophageal cancer, it starts to climb up. Around the same time,
the food industry began to shift how they added sweeteners and shifted from cane sugar and
beet sugar to a much less expensive, more readily available crop corn and developed high
fructose corn syrup which today goes under many names
and sometimes hard to decipher, but what it is, is a very
inflammatory sweetener. The inflammation in that sweetener, some of those chemicals, loosen
the lower esophageal muscle. The reason why that’s a big deal is the acidic
stomach sits underneath there. You have to think about
what’s going on now. You’re eating and drinking
various acidic things and you’re having
sweeteners that loosen, so it’s essentially a double whammy. Acidic things this way,
loosening this way, and it’s causing a lot of inflammation. Sure enough, slowly, steadily,
the incidence of esophageal cancer, it’s called Adenocarcinoma. “Adeno” is the Latin term for gland, so it’s esophageal cancer, not from smoking and
drinking in excess. This is from acidity began increasing
then. You can almost trace it back. In terms of who’s at risk, 75 million Americans have
gastroesophageal reflux disease. We’re all at risk. The scary thing is a lot of
people don’t have the traditional symptoms. Only 1 out of 10 people that come to see me
in the office are complaining of heart burn. Most people complain
that they have a drip, that they’re coughing,
that they’re hoarse, and we have to ask them
questions about what they eat. When’s the last time your doctor asked
you any questions about what you eat? When I start asking people,
“Do you drink soda or bottled iced tea?” They look at me like I have nine heads. Hey, it’s important to
ask these questions. If you’re not being asked
these questions, say, “This is what I’m eating
and drinking. Is this okay?” Or bring in even a 10-day food diary,
or if that’s too much, a 3-day food diary. When you’re in the waiting area,
you can just write that down. This is what I had for breakfast,
this what I had for dinner last night, this is how many hours
I stayed up after my last meal. These are seemingly innocuous
questions but really, you’re giving your clinician
the keys to a lot of these symptoms. What we say about acid
reflux, it’s 2 things. It’s what you eat and when
you eat. What and when. What is things that are either
acidic as you consume them or materials, foods really that
have physiologic functions. I’ll give you a perfect example. I call it “The Dirty Dozen”. There are 6 foods that loosen the muscle
that separates the acidic stomach from the non-acidic esophagus and there’s 6 foods or food categories
that are extremely acidic as you eat them. Let’s start with the stomach side, what I call the “Dirty Half Dozen”. It’s coffee, chocolate, alcohol,
mint, raw onion, raw garlic. Everyone’s saying, “Oh my god,
my 6 favorite food groups. I can’t eat anything anymore.” Not the case, but what all those
substances have in common is they will loosen that muscle
that separates the acidic stomach from the non-acidic esophagus. When you take away that muscle, you loosen it,
things here can shoot up. Now, coffee and chocolate
have particular properties. They’re not acidic, so when you hear,
“Hey, I got low acid coffee,” what? Coffee has a pH of around 6,
so just a little science, anything less than pH 7 is acidic. Anything more than pH 7
is considered alkaline. As you get lower and lower in
the number, it’s more and more acidic. Things less than pH 4, 4 is the magic number, are extremely
acidic and can cause a lot of problems. So we want to really stay above 4, and if we can’t, at least
initially to heal, above 5. How do coffee and
chocolate play in here? Coffee and chocolate, not that acidic,
pH 6. But what do they do? They not only loosen
the lower esophageal muscle, but they also increase acid
production by the stomach. The idea of an after
dinner coffee, say, Madrid style,
it’s 9:00, 10:00 at night, you have a 6:00 a.m. meeting so
you got to be lying down by midnight. “I’ll have a coffee.” You have your coffee
and what happens? It loosens the lower esophageal
muscle and acid is produced. It takes the stomach
3-4 hours to empty. You finish eating 8:00, 9:00 or 10:00, and if you’re not staying
upright for 3-4 hours, when you lie down, you take
away gravity and things come up. When you add something that produces
acid in addition to lying down too soon, you can see you can have problems. There’s an enzyme in the stomach that
breaks down protein called Pepsin, P-E-P-S-I-N. Pepsin normally sits in the stomach and it
gets activated at very acidic environments. The stomach is very acidic.
Again, less than pH 4. Pepsin was found a few years ago,
not very long ago, to float. Where does it float to? It floats up.
It can sit on the vocal cords. It can sit in the sinuses. It can sit in
the middle ear spaces, in the lungs. When you eat or drink
something less than pH 4, it turns on and what you
eat starts eating you. Again, I call them the “Dirty half dozen”. Easy to remember. Two of them we shouldn’t be eating
or drinking anyway, and what is that? Sugary or diet soda, sugary
or diet bottled iced tea. Really, almost any beverage in a can,
bottle or box is very, very acidic. The way I look when people say, “Oh,
I just have 1 or 2 of those a month.” I say, “Only pour battery acid
down my throat twice a month.” That’s what it’s like and people
dismiss and I get the hand wave, no. But then there are
4 healthy things which I call the “Four Under Four”, meaning the 4
substances under pH 4. What are they? Citrus, tomato sauce, not tomato,
tomato sauce, vinegar, wine. Again, I can hear the groans. “I have the best
wine collection east of the Mississippi.” Okay, but you should be aware,
if you’re coming in with certain symptoms and you’re eating and drinking
certain things, this is why. When you eat or drink,
say, a balsamic vinegar, it’s acidic and it releases,
activates tissue-bound pepsin and causes inflammation. It gives you the hoarseness.
It swells the sinuses. It can irritate the lungs. This we really didn’t know and it gets a little more interesting
because as little as 2 years ago, it was shown that when
you have an acid injury, it’s not just a superficial
injury that if you keep, keep eating or drinking certain things,
it gets deeper and deeper. That’s not what happens. As soon as you eat or drink
something that’s very acidic, you get a body-wide
inflammatory response. This was absolutely shocking.
It only came out in 2016 and the reason why
this is so important, you’re getting a body-wide
inflammatory response. What was clinically, you know,
we’re saying to patients, “Get on the Acid Watcher Diet.
Avoid these very acidic things,” and then they’re coming back to us and
saying, “Hey, my psoriasis went away. My Crohn’s disease improved. My irritable bowel improved.” As it turns out, this body-wide inflammatory
response is what’s happening. While we’re recommending this diet, we’re paying
attention to what our patients are telling us and how the science
is sort of backed into what we developed and it’s telling us that
it’s going to help inflammation everywhere. That was wonderful to see and when
science supports clinical observation, that’s always something
that you could build upon. Let’s talk about
smokables for a second. Every day, people come in and they
say, “I don’t smoke, I just vape because vaping’s okay because you’ve
taken out the tar so I won’t get cancer.” I wish that were the case.
That’s not the case. Again, very recently, there was a big study out of the Department
of Pediatrics at UC San Francisco that showed that the chemicals
used in the vaping process, the propylene glycol and related
compounds are carcinogenic. They identified 5,
they’re all carcinogenic. We’re talking beyond acid reflux. We’re
talking about an inflammatory response to the lungs as well
as to the vocal cords. We don’t know yet the effect because it
hasn’t been around long enough to see but when some of the most respected
scientists in the world are saying these inhaled agents,
even though it’s not as hot, you’re still doing enough to them to cause
tissues to transform or become cancerous. It really gives you pause. Now, ingestibles are a different story. If you want to, say, eat marijuanaÑ
we’re going to go to marijuana a little bitÑ if you’re going to eat marijuana, okay,
it’s not carcinogenic as far as we know. Your gummy bear or the equivalent, but as soon as you ignite it,
you release something called a TIF. A TIF isn’t a digital file. It’s a tumor initiation factor. You have to be very, very cautious
when you light something up. Eating it is one thing. Lighting it up, burning is another and you
get into a very, very tricky, dangerous area. How this backs into acid reflux and
some that we’re talking about here, tobacco now and marijuana similar
although probably more potent, will loosen the lower
esophageal muscle, again, taking away some of the natural
protective mechanisms that we have. Cigar is one of my favorite topics because people come in and say, “I don’t inhale,” and I always think, how can you tell a microscopic
smoke particle where to go? I spent almost 10 years as a Director of Head and Neck surgery at
Columbia doing cancer surgery on cigar smokers. We had to remove part of their lip,
part of their tongue, part of their cheek. Even though they told
the smoke to go that way, it didn’t listen and went that way. These are carcinogens.
You can call it what you want, that’s what they are. The, say, 1,000 head and
neck surgeons in the United States don’t have time to tweet about this or post Instagram posts about it because
they’re busy taking out these tumors, but that’s what happens.
Smokables are very risky. Allergies are a specific
response to certain substances, but what do allergies do or cause?
The tissues swell. They get irritated. Sometimes, when someone comes in
with sinus-type complaintsÑ pressure, dripÑ they sound like this
because their nose is clogged, they’re clearing their throat a lot, it mimics allergies.
But as we discussed, when you eat or drink these
handful of very acidic foods, the healthy onesÑ citrus,
tomato sauce, vinegar, wineÑ you can actually swell your sinuses and it mimics exactly the symptoms of someone
who’s, say, allergic to ragweed or a grass. How do we tell the difference? We get formal allergy testing which our
allergists and ENT and Allergy Associates can do. It’s very straightforward. Very often, the patients will come
back, you don’t have allergies. They say, “Why do I sound like this?” Well, it’s what you’re
eating or drinking. We’ve now educated everybody and our first line when people come
in with allergy-type symptoms, yes, we’ll send them for
an allergy investigation or maybe they’ve already
had an allergy work-up, but we will tweak their diet
a little bit and again, let them know. When you explain the science,
it makes sense. If you just say, “Hey, it’s what you’re
eating,” you don’t give an explanation, they think you’re nuts.
But when you say, “Look, it’s pepsin. Pepsin floats. It sits here.
You drink. “Oh yeah, I have, you know, my favorite dressing
is was raspberry vinaigrette. I have it only at lunch and at dinner
every day for the past 9 years. It’s the best.
It’s the best.” Right? That’s how they sound.
“It’s the best!” Well, maybe not. Let’s tweak it.
Let’s try something else. This is where allergies
and acidity sort of cross. Most people probably
don’t have allergies. It’s probably what they’re
eating and drinking. It gets confusing. “I have acid reflux?
What’s that got to do with allergies?” Well, it’s about swelling and the question is,
where is the swelling coming from? We want to rule out every way
possible how something can get inflamed. Sometimes it is allergies. Sometimes it is what you’re eating.
Sometimes it’s both. There is a documented
relationship between being significantly overweight, acid
reflux disease and esophageal cancer. The simple way to think of it is when
you have a lot of pressure here, you’re actually pushing on the stomach,
especially in certain positions and the inflammatory material
comes up like we talked about earlier, the acidityÑ and this is a very
direct correlate of acidity coming up and pressure from weight coming up. There are associations. Now, what we have found is
anti-inflammatory diets will, especially as you follow them,
you will tend to lose weight. There are 2 ways
we’re doing this. One, having foods that aren’t very acidic
so you reduce inflammation and then it’s also a high-fiber diet. When you’re eating plenty of fiber,
you’re actually moving things along in the body and it was again recently shown
that when you eat a lot of fiber, you reduce inflammation in the gut. You actually help the gut microbiome. A test for acid reflux
comes in many forms. One is by history, you know,
what the patients are telling us. Say, “I come home every
night at 9:30, 10:00. I just got back from the gym. I grab something to eat.
I’m exhausted and I lie down.” Okay, we know the stomach
takes 3-4 hours to empty, simple math, it’s only 90 minutes, stuff’s going to come up. Again, these are people with symptoms.
People are coming in, “I’m hoarse,” “I got a lump in my throat,” “I can’t swallow,”
“I got a sinus drip,” and 1 out of 10 are saying,
“I have heartburn.” Again, most of it is up here.
I just want to say one word, how you can have
“acid reflux” without heartburn and this is a way to look at it. When you have constant
inflammation in a part of a body, the tissues swell. When tissues swell, they
become numb, you feel nothing. If you think about a little
torch has a little fire and then keeps coming up, keeps coming up. Let’s
say the source of the torch is the stomach. Initial fire comes up and it’s swelling
the tissues, tissues become numb, but then it keeps coming up and
you start to feel the throat piece. Again, I don’t want to confuse this with
the acidity of what you’re putting in your mouth but this is just this way, right. Tissues swell, they become numb, you don’t feel anything.
“I don’t have heartburn.” What you have is you don’t
have sensation, that’s the problem. When people say, “Oh, I used to have
heartburn and one day, it went away.” One day it went away? No.
What happened was you got so inflamed, your tissues became numb,
you don’t feel anything. 15% of people that
present with throat symptoms will have potentially
esophageal pre-cancer. That’s called Barrett. That means stomach
lining creeping up into the esophagus, 50% of that could
potentially become cancer. That’s why we want to look.
How do we make the diagnosis? You can look. You can look by
putting a little camera on the nose and looking at the throat. You put a little camera in the nose,
you can look into the esophagus. You can get sedated
and have an exam through the mouth looking at the esophagus,
stomach and upper part of the small intestine. There are physiologic tests.
There is something called pH testing and there are various ways there. You can actually look at the number
of acid events over a period of time. There are many ways. We always
start with what the patients tell us and then what we see on exam
and then we take it from there. About 20 years plus ago,
probably in the 90s, a class of acid-reducing medications
called proton pump inhibitors were developed for use in the United
States and around the world. They are among the most effective
acid reducing medications ever and their symptoms went
away and it suddenly was like, “Take this pill, eat what you want.” That’s almost became a mantra. “Don’t worry about it.
Put it in the water supply.” Of course, as time went on, we began to read about
reports of side effects of these medications. Now, I want to say before I scare
everyone with the side effects, there’s never been a single controlled study
about these medications and side effects. These are all observational studies, meaning they’ve taken
a large group of patients, they’ve looked at them and they said,
“Ok, well, you had a heart attack. You’re on proton pump inhibitors,
therefore there’s an association.” That’s weak science at best. There is some association
from these medications and it’s really the proton pump inhibitor,
but what would people worry about? Worry about kidney problems,
worry about bone fractures and there’s this smattering of
associations related to dementia. A typical proton pump inhibitor will
suppress 80% of acid production for a 12-hour period. There are less strong acid reducers that go by the name Ranitidine or Famotidine,
the brand name is Zantac or Pepcid, that suppress about
40% of acid for 4 hours. About a third as potent and we really don’t see
the same long-term side effects. There are other ways to use
medication if you have to, but in general, what we’re trying to do is stay
away from medications as much as possible, now backed by food solutions
and diet and lifestyle solutions. We’re trying to stay away from
a pharmacological solution if we have to. Now, if you have
esophageal pre-cancer, that’s a different story and we
have a discussion about that. Again, this is all about educating
our patients and our friends what you’re eating
plays a huge role. One of the reasons we’re in favor
of organic fruits and vegetables if you have access to it is that
a lot of the nutrients are preserved. When pesticides are used,
when hormones are used, when antibiotics are used, it’s going to affect the quality of what
you’re ultimately going to be eating. When we talk about foods
that have preservatives, often the chemicals in the preservatives
will loosen this muscle here between the esophagus
and the stomach and allow passage the wrong way. Some of the genetically-modified foods,
again, the preservatives, the chemicals used have
inflammatory effects. Whether it’s a direct loosening
and causing acid this way or body-wide inflammatory response
because of the chemicals that are being used, we really, as much as possible,
want to stay away. You want to get a beverage,
you want a cup of coffee a day and you want a non-dairy milk, some almond milk there,
some soy milk there in the store. You prefer not to have a GMO soy. You prefer not to have a chemical-laden
almond milk but sometimes that’s all you have so you do the best you can. I myself read about people
making their own almond milk. I’m like, “Almond milk? How am I going
to do that? I have to buy a nut bag?” I’m likeÑ but as it turns out,
it’s not a big deal, you can do it. The point is, the more whole
food, natural food you have, the better it is for your body,
meaning less chemicals, less inflammation. We developed a low acid,
high fiber diet. It’s called the Acid Watcher Diet,
and there’s some basics in there. We want you to have,
if you can, this is the idea, a pound of vegetables,
half a pound of fruit a day. A pound of vegetablesÑ four carrots,
medium-sized carrots is a pound. When you go to your salad bar, almost any of these salad stores, they’re
giving you a pound of veggies right there. If you don’t want to do that,
throw it in your morning smoothie. We take half a pound of fruits,
sometimes we add vegetables if the fruit is acidic, say, something
like a pineapple or even an orange, you can neutralize it by
adding what I call CARS, C-A-R-S. Coconut, almond, rice, soy. Anyone of those non-dairy milks will
neutralize the acidity of, say, a pineapple, the acidity of an orange. You can have those tastes
without the inflammation. You’ll get your half a pound of fruit,
you can get your pound of veggies. You could take kale,
you could take spinach, you can slice up your
carrots, your cucumber. These are ways to get your
fruit in at the start of the day. It almost doesn’t even matter what
the rest of the day brings you. One of the advantages of fruits and
vegetables is the amount of fiber, also seeds.
As it turns out, chia seeds, a tablespoon,
has 5 grams of fiber. 3 tablespoons in your morning
smoothie, that’s 15 grams of fiber. That’s a lot of fiber in an
8-16 ounce beverage. There are ways to do this very creatively
and in a delicious way right off the bat. We know that fiber, we know that
low acid will decrease inflammation. These are not only preventative ways to handle
acid reflux disease but also treatment ways. I call the combination of watermelon
and cucumber food steroids. Why? Watermelon has the greatest concentration
of an anti-inflammatory agent called lycopene. For years it was thought
that tomato, its red color, had the highest source of lycopenes and
urologists would say to their male patients, for prostate health,
have a tomato. Well, as it turns out, watermelon has
even more lycopenes per unit weight. For overall health,
have a watermelon. Cucumber has something
called a lignan, L-I-G-N-A-N. Lignans are also powerful
natural anti-inflammatory agents, so are flax seeds. You could take a handful of ice,
a cup of watermelon, a cup of sliced cucumber,
you can leave the skin on, ideally the organic seedless
one but it doesn’t have to be, throw in a tablespoon of flax seeds, press play on your blender and you
have an anti-inflammatory beverage. In fact, for a lot of the singers and performers
I take care of when they’re in the studio or on tour, I’m not going to
keep giving them steroids. I have them have watermelon,
cucumber every day, whether they eat it, whether it’s in a beverage, it’s an
incredible anti-inflammatory food. I trained as a head and neck cancer surgeon
and a microvascular reconstructive surgeon, and what we found
after we treated people is they had tremendous problems.
There was some disfigurement. Even more important,
they couldn’t swallow. Our whole goal was to try and
get people taking food by mouth, not having to rely on a feeding tube. As we looked more
and more into this, we realized that what people
were eating and drinking were a problem post-op and
then we took it a step further. Instead of focusing on the problems
once the horses are out of the barn, why don’t we get it while
we’re still indoors, as it were. That’s where the food
solution sort of came, you know, to be a growing
obsession, if you will. I mean, it happened to me. I woke up in the middle of the night in
my fourth or fifth year as a cancer surgeon while I was at
Columbia University, choking. Literally, I woke up in
the middle of the night, I couldn’t move air.
I didn’t know what was going on. I figured out something
was going on and I closed my lips and I sniffed
and that opened my airway. I went to my doctor, he’s like,
“I don’t know, it’s an allergy. You’re stressed. Drinking too much
coffee. I don’t know, I don’t know.” And then I realized it was
probably what I was eating. You know, that 32 big
ounce, big gulp of, I don’t know how many milligrams
of caffeine were in this thing. My diet was giving me symptoms and it took a long time because
the science really wasn’t there. You know, so much of what I’ve told you
today is about studies in the last 24 months. There are certain things we knew. The pepsin issue really
helped us, meaning certain things that you’re
eating, you’re drinking, are going to activate quiet cells or quiet enzymes
that then could wake up and cause problems. It’s through that that we
began to move in this area. I think it’s all about
education and awareness. We just don’t know or didn’t know. Now we’re knowing and
we’re slowly moving it out. But really, it’s going to be
because of people like WellBe. You’re going to reach many, many more
people than I’m going to be able to reach. As you reach out to
your growing audience, you’re going to be
the agent of change. We can only scream so much. It’s a patient at a time, but what you’re doing, you’re
reaching thousands or more at a time. This is what we hope to accomplish. Working together, we can do this.


  • Sick Boy says:

    Amazing video.

  • Prtygrl44 says:

    such a Brilliant man!

  • Adam Kulka says:

    Thank you Dr Aviv, you have helped me a lot.

  • S. Garr. says:

    Acid reflux can trigger sinus/sinusitis issues?!? 😳😲

  • Tom Ashworth-Jones says:

    I'm really suffering with my IBS and GERD problems right now and this video helps explain so many things that have confused me before. He puts it across very clearly so that the information sinks in, and you know it makes sense. Thankyou so much for this! I will be using this info to hopefully end some of my problems.

  • Logic Realty says:

    I have throat reflux,..thank you for posting! love this Dr.

  • Kell Rudolph says:

    Thankyou so much for sharing your knowledge Dr Aviv, thats the best informative explanation Ive been given by a Doctor – Im usually stared at blankly when I describe my symptoms. I have gerd, oas and eoe highly likely from my terrible diet and its affecting me everyday now, Ive got so much inflammation going on in there that it affects my breathing. Im hoping you can advise of some great acid watch meals.

  • Bonnie Friesen says:

    Hi! I’ve been on the diet a week just over a week now, and I am seeing results. I would like to know if there are any published studies done on the floating pepsin’s etc that I can share with my family doctor to inform him of this? It would be very helpful!

  • Lorna Harwood says:

    Thank you Dr Aviv your video has been so informative.  I watched you video and realise I believe I am suffering with throat burn reflux and now I have a numbed effect.  There has not been a Dr that has taken the time to explain in great lengths as you have. Thank you.

  • M311Y says:

    This is very enlightening to me on a deep level. Thank you. Watermelon cucumber smoothies sound great also.

  • Taylre Griffin says:

    I suffer from GERD and IBS and I've tried everything for my IBS but only recently learned that I have GERD! I have always suffered with chest pain and nausea and never knew until recently that that could be gerd, my doctor always told me I just had a nervous stomach but then finally listened and put me on a proton inhibitor and my life has CHANGED! I'm very young though so I don't want to be on proton inhibitors for the rest of my life, I am so hopeful that this diet will help both my GERD and IBS. This video was so eye opening, than you so much.

  • senzy ch says:

    Thank u for yo vedio, very informative. I have i been diagnosed with chronic acid reflux. I have lost a lot of weight i cannot eat. I feel like something is stuck on my throat..

  • Susan Daniels says:

    This is an excellent video.  Thank you Dr. Aviv, you made it possible for me to swallow comfortably, normally again!

  • Necey Kornegay says:

    This video is very good information.I thank you for this and i pray i can get better with it.God bless u.

  • Jovan Krstic says:

    what a gentleman

  • Charlotte Friedman says:

    Thank you Dr. Aviv. So much great information in one video – no wonder you are one of the vey best in your field.

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