Dr. Jamie Koufman saw a patient in 1981 who had benign growths in her throat caused by acid returning from the stomach. She diagnosed it as reflux disease, only to have many of her peers dismiss it.
“I couldn’t get anything published on reflux for almost a decade,” Koufman said in an interview.
Now the diagnosis is commonplace. About 20 percent of U.S. adults have gastroesophageal reflux disease, according to the Milwaukee-based International Foundation for Functional Gastrointestinal Disorders. It occurs when stomach acid comes back up into the esophagus, causing pain, hoarseness, coughing or difficulty swallowing.
Koufman established the nonprofit Voice Institute of New York, which provides medical care for those with larynx disorders, acid reflux and vocal ailments.
The ailment has hampered and derailed the careers of opera singers and others who use their voices for a living, Koufman said. A study of 351 singers by a researcher at Catholic University of Medicine and Surgery in Rome showed that they had a higher incidence of reflux than the general population.
Koufman now preaches a low-fat, low-acid diet, whose effectiveness she argued in a study published in May in the Annals of Otology, Rhinology and Laryngology. Her findings are that acid-reflux symptoms sharply declined or ceased after patients adopted such a diet.
“I have a patient with chronic cough who is in her 70s, and we treated her reflux with medication and with a low-fat diet. And after 42 years, her cough is better,” said Koufman. “Many of my patients have been basically cured by changing their diet.”
Koufman has invested $200,000 in publishing “Dropping Acid: The Reflux Diet Cookbook & Cure.” She worked with Dr. Jordan Stern, an acid-reflux specialist and founder of the sleep-disorders center BlueSleep, and Marc Bauer, a master chef at New York’s French Culinary Institute.
The book’s 75 recipes support the message that people should avoid fatty and acidic foods such as chocolate, carbonated beverages, deep fried foods, ribs and coffee. They should instead favor foods such as bananas, grilled or steamed chicken, egg whites and raw or cooked vegetables.
“The diet is a good idea,” Dr. Roy K.H. Wong, the integrated chief of gastroenterology at Walter Reed Army-Navy Medical Center and a professor of medicine, said by phone. “Whenever you eat fatty substances, they stay in the stomach for a longer period of time, and the fat slows down the emptying of the stomach.”
Word of Mouth
The self-published book has sold about 7,500 copies by word of mouth and has attracted more than 3,400 to its Facebook.com page since its publication. Sales of the book will support the Voice Institute.
Dr. Christine Frissora, an associate professor of medicine and a gastroenterologist at New York’s Weill Cornell Medical College, said “Dropping Acid” won’t cure all those with acid reflux. A patient who has advanced reflux or Barrett’s esophagus, a precancerous condition, will need medication. If left untreated, “it can develop into esophageal cancer,” she said.
In “Dropping Acid,” Koufman recommends that those with reflux avoid processed foods. “Everything in a bottle or a can is acidic,” she said.
Chicken stock is used for flavor instead of lemon juice or white wine in recipes for codfish and Asian-style shrimp with jasmine rice.
“Classic French soups and sauces are usually finished with butter or cream because the fat helps the flavor stick on your taste buds,” Bauer said. “I avoid it by using flavoring” such a small amount of “cheese that has a nutty taste.”