Are you one of the millions of Americans who struggles with reflux issues? Don’t just be a statistic, or settle for a half-measure when there are viable solutions! Today on the Gut Health Reset Podcast, we are going to address reflux and the common causes. We’re going to dive into lifestyle changes that you can make that will potentially help your reflux and to know what’s normal and what’s not with reflux. We’re going to talk about the different types of reflux, the underlying causes and what next steps should be to maybe investigate the cause of your reflux with Dr. Peter Belafsky and Dr. Ramon Franco!
We answer these questions:
– What is reflux? What about gerd?
– When do you need to become concerned about reflux?
– Are antacids good long-term solutions?
– How does H. Pylori factor into reflux issues?
– What lifestyle changes can help beat reflux issues?
– How does coffee factor into reflux issues?
– And more!
Still want to learn more? Schedule with Dr. Barter today!
Constipation Support 1: https://drannmariebarter.com/product/constipation-support-1/
About Dr. Peter Belafsky and Dr. Ramon Franco:
Dr. Belafsky followed in the footsteps of his father and grandfather to “join the family business” by becoming a physician. The desire to comfort his patients and ease their pain runs deep. His distinguished career has been guided by the overwhelming drive to help people feel better in order to live happier lives. Since completing medical school and a residency in otolaryngology at Tulane University, followed by a laryngology fellowship at Wake Forrest, Dr. Belafsky has dedicated his extensive research and clinical practice to those suffering with voice and swallowing problems. Every day he sees patients suffering with the pain of reflux. Every day he wants to be able to do more. Reflux Gourmet is another step towards more.
Dr. Franco is also the son of an otolaryngologist. His belief that every person deserves the highest quality of healthcare drives his work.
Dr. Franco enjoys the academic world of medicine where he strives to increase patient safety while decreasing their financial burden through innovations such as shifting procedures from operating rooms into the office and investing himself in endeavors like alternative reflux therapy. Alginate therapy, the foundation of Reflux Gourmet, aligns perfectly with his view of how medicine should help everyone.
You can find them at: https://refluxgourmet.com/
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Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com/
followed by a fellowship at Wake Forest, Dr. Belafsky has dedicated his extensive research and clinical practice to those suffering with voice and swallowing problems. Every day, he sees patients with pain of reflux. Every day he wants to do more. My second physician that I’m interviewing today is Dr. Franco, who is also the son of an otolaryngologist. He is also a celebrated Scientologist himself based in Boston. He has a belief that every person deserves the highest quality of health care. That is what drives his work. After graduating medical school from Pennsylvania State University, Dr. Franco completed his Bodoland allergy residency at the State University of New York, followed by a fellowship at the Massachusetts Eye and Ear Infirmary Harvard Medical School. Dr. Franco enjoys the academic world of medicine where he strives to increase patient safety while decreasing their financial burden through innovations such as shifting procedures from operating rooms into offices and investing himself in endeavors like alternative response therapy. Dr. Franco attends a busy practice while maintaining his clinical research. He is a frequently invited speaker to conferences around the world. He also volunteers for philanthropic medical missions and teaching surgeons. Thank you so much for joining me here today. We’re super excited to have you guys and we are going to talk all about reflux today, so we’re going to get into this. So without further ado, what is reflux?
Dr. Peter Belafsky [00:03:56] I’ll take the phone reminder if you want the people to simply like we all reflux, it’s a it’s an essential physiologic mechanism. The stomach needs to vent gas. And in simplest terms, the purpose of reflux is the stomach necessity to to relieve gas. We all burp, probably somewhere upwards of 30 times a day. It’s normal. We swallow about 15 cc’s of air every time, every time we swallow, which is about a thousand times a day. So the stomach needs to vent that gas. When we vent that gas, the lower sphincter of the esophagus relaxes and we what we experience is a burp. But sometimes with that burp stomach contents can come up with that. And that’s what we call physiologic reflux. So up to 50 times per day for these lower relaxations of the distal esophagus is considered normal. You wouldn’t want to be without it. You’d be very bloated and distended and be farting all day, essentially.
Dr. Ann Marie Barter [00:05:07] So, so what’s the difference between something reflux that maybe needs medical attention versus reflux that it’s just normal function of the GI system?
Dr. Peter Belafsky [00:05:21] So gastro esophageal reflux disease would mean symptoms that are bothersome, so you could have physiologic or normal amounts of reflux and just have a very sensitive esophagus or throat and experience discomfort. So for you that normal amounts of reflux may be abnormal for you because it’s causing you discomfort. Other people, you know, may not experience such discomfort when they’re regurgitating or when they reflux. But the actual stomach contents may cause injury to the esophagus or to the throat, and then they don’t get heartburn. But they may present with swallowing problems or even cancer more hoarseness or cough. So, you know all these symptoms that are so common for all of us.
Dr. Ann Marie Barter [00:06:14] Well, you dropped a bomb there like you or maybe cancer. So when are we getting to a point where we potentially need to be concerned about GERD? So I’m just going to shorten it? When when do we get to a point where that’s more concerning and we really need to look at seeking care?
Dr. Peter Belafsky [00:06:36] Danger signs, are you getting stock that’s a big, huge red red flag for us, getting stuck more than just intermittent symptoms, so excessive regurgitation or pain or cough cough is also another dangerous system symptom that process for more than eight weeks. Unexplained weight loss. Offices are coughing up blood. Those are kind of dangerous, and hoarseness that persists for longer than three or four weeks is also would be a dangerous time for us.
Dr. Ann Marie Barter [00:07:14] And what about more of sinus symptoms? Are you are you noticing maybe a presentation that can look a little bit like allergies when it could actually be reflux?
Dr. Peter Belafsky [00:07:27] We’ll take this one.
Dr. Ramon Franco [00:07:28] Yeah, sure. Yes. So it’s something that has been established, especially in children, where the the adenoids can get inflamed and then that causes problems with the ear so they can have ear infections that are recurrent as well as sinus issues. And we do see that in adults as well.
Dr. Ann Marie Barter [00:07:48] And can you clarify for some of the listeners what the ad notes are?
Dr. Ramon Franco [00:07:52] Oh, sure. So the adenoids are a it’s a lymphoid pad in the back of the nose and what we call the nasopharynx. And the way you have to think about the lymphoid tissue is that it’s distributed throughout the the back of the throat. So from the back of the nose, the knees, pharynx into the throat and the bottom of the tongue. And that form is a ring that we call wall DIYers ring. And it makes sense because that’s where we we sample the environment. The outside comes into the inside and it has to hit the back of the tongue, the throat. So we have lymphoid tissue there to help protect us.
Dr. Ann Marie Barter [00:08:27] OK, so so let’s say kid has this one, adult has this and they go into their primary and generally the first course of action tends to be a prescription for a proton pump inhibitor and correct me if I’m wrong here. So p also known as a P.I. So why? Why is that maybe is that concerning at all to be on that long term? Or when do you know, hey, like we need to do something else with that treatment method because a lot of folks are on PPIs for years, upon years, upon years.
Dr. Peter Belafsky [00:09:04] The issue with puppies is, you know, we’ll just let’s just talk about, let’s call them and ask them to drive because there’s proton pump inhibitors and everyone knows these is like Prilosec, the German generics, omeprazole photonics, Nexium, massive factors like a half dozen of them. But there’s also the H2 blockers, which are Zantac, Pepcid or probably the two most common their acid blockers. They don’t actually prevent reflux. They’re just an acids, so you can still have symptoms you eat, you know, a cheeseburger for lunch or something, or even like an acid ball or something. And if you eat too much, your stomach’s to fall or is just delayed and emptying. It can regurgitate and come back up into your esophagus, even into your throat. So the picture that the antacids don’t prevent that at all, they just increase the age of your stomach. So the what is regurgitated is less likely to cause tissue injury, but you can still get symptoms. You can still get irritation of your upper airway. Your regurgitated contents can also end up in your lungs. So the PPIs, really, they’re not an anti reflux medications. They’re very effective in acids. So the it’s not acid that causes injury. And again, all the. Puppies and H2 blockers do is increase the age of the stomach, it’s actually the proteolytic enzyme pepsin that causes tissue injury and pepsin can actually adhere to the lining of your esophagus in your throat and then be Enda’s side toast or sort of stick to the lining of your throat and esophagus. And then when you regurgitate later in the day, if there’s if it’s acidic, it can activate that pepsin and cause tissue injury. So the puppies, H2 blockers are very effective at preventing tissue injury, but they’re less effective at really eliminating symptoms because they don’t prevent reflux.
Dr. Ann Marie Barter [00:11:16] So in a situation where, say, reducing or actually increasing your stomach acid would be effective would be in a situation where you have an ulcer, for example, because you’re saying that, Hey, let’s stop tissue damage here, let’s stop erosion. And so that’s a really important point. So how how long is maybe an ideal time for people to be on antacids?
Dr. Peter Belafsky [00:11:42] Well, the issue that the majority of people with symptoms don’t have erosions,
Dr. Ann Marie Barter [00:11:47] and that’s what I’ve noticed.
Dr. Peter Belafsky [00:11:49] Yeah. So it’s 20 percent do. And maybe even a little less than 20 percent, maybe even closer to 12 percent, have actual tissue injury. The difficulty is knowing, are you in that 12 percent or, you know, are you in the, you know, are you in the the larger group that’s less likely to have the tissue injury? But if you don’t have tissue injury, it’s really a symptom driven disease and you don’t need to be on chemicals at all. You can handle it with behavioral modifications with alginate therapy just when changing your diet, right? But if you’re in that 12 percent that has tissue injury, that injury can be really damaging. It can cause swallowing problems that can persist for a lifetime and it can cause cancer. It can cause all types of problems. So it’s really just, you know, if you’re in that 12 percent, you really need to be on the effective prescription medications. If you’re in the larger category that doesn’t have tissue injury, you can really handle it without drugs.
Dr. Ann Marie Barter [00:12:55] Yeah. So the other modification that I hear made a lot, and I’d love to hear what you guys think is to sleep sitting up. For a moment, you want to take this one.
Dr. Ramon Franco [00:13:08] No, would say so. You know, when I when I see patients in the office, the first thing I start out with is let’s let’s talk about diet and behavior modifications, right? Medicines are short term. Just like we were just talking about, you know, you don’t want someone on proton pump inhibitors for the rest of their lives. And there’s really no need for it. The things this is more of a lifestyle problem. We’re doing things to ourselves that increase the propensity for the stuff to move from the stomach into the esophagus and then into the throat. So diet, I tell them things like caffeine, things like mint chocolate. These things have chemicals inside of them that can cause relaxation of the lower esophageal sphincter. So when you think about it, your stomach is this bag where you pour stuff into it. Right. Solids, liquids and the stomach’s job is to grind all of this stuff to increase the surface area for all these enzymes to come and break everything apart. Well, it’s very efficient at this, but it’s a bag that only has two ways out up to the esophagus or into the intestines, right? Your abdomen is seeing relatively high pressures, right? You have this wall around it all around it, so the pressure is high. The chest where the esophagus is is very low pressure. So there’s a natural tendency for things to want to get sucked up into the into the chest area, into the esophagus. So we have the lower esophageal sphincter, which is there to basically be a gate and stop that. Well, if you’re now loosening the the function of that gate, well, you have a problem, right? And the more you feel the stomach, the more stuff is going to come up into your esophagus and give you symptoms. So eliminating those things that can decrease that tone things such as like spicy foods, if you eat a lot of very low things. So, you know, diets, diet soda, very low. That is going to reactivate the pepsin that’s sitting inside of your throat and your esophagus, even without reflux, sing up anymore. So if you just have pepsin peppered in there, it’s going to reactivate that pepsin. We go over things like making sure that you don’t overdo stand the stomach. So instead of having a very large meal, it’s better to have maybe two or three smaller meals so that you’re not over just ending it, increasing the propensity for things to shoot up into the esophagus.
Dr. Peter Belafsky [00:15:24] So now that the stomach takes about four hours to empty. So in addition to elevating the head of your bed, you really want to go to bed on an empty stomach. And if the patients we tell our patients, if you’re going to do one thing like shut the kitchen, put a lock on the refrigerator at six o’clock at night and don’t lay down until 10:00. And if they just do that, the majority of patients, especially if they’re in the non injury category, are really going to do fine if they just listen to that.
Dr. Ann Marie Barter [00:15:55] So many people struggle with bloating, bowel issues, brain fog, fatigue. You might not even have any gut issues, but did you know the cause of it could be food sensitivities or gut infections? What I have done is I have brought a talented functional nutritionist into my practice. We have very similar training in the nutritional world. And her name is Alexis Appleby. She is awesome. So you can head on over to our website ult. alti fam fam Med Medi- and have a consultation with her and schedule so that she can help you get to the root cause of your problems. I don’t know about you, but people have a really, really difficult time not eating about three hours before bed. I know I’ve seen it, I’ve seen it over and over again.
Dr. Peter Belafsky [00:16:48] All my friends, I get home from work and they finally put the kids down and then they want to sit down with their significant other and have a glass of wine. And you know, it’s 9:30 before they’re even putting their feet up. So it’s hard. But if you can really shut the kitchen early five or six o’clock, you can really prevent a lot of the nighttime injury that happens. And also, like you said, getting gravity on your side. What is it? Gravity is like 9.8 meters per second, right? So we want that gravity on our side, so the stomach preferentially drains instead of x up.
Dr. Ann Marie Barter [00:17:25] The ongoing debate has been, you know, do we are we too acidic? Do we have not enough stomach acid reflux, et cetera? And I think every case is individual, right? If you have an ulcer, you’ve got too much of you potentially on reflux that might not be enough. Who knows? What’s your feeling on? Not enough, too much stomach acid? What’s your thought on that?
Dr. Ramon Franco [00:17:50] So I would say that this is not really, I guess it’s not necessarily too much acid, too little acid. It’s where is the acid, right? So if you took that same stomach acid that lives very nicely in the stomach and put it on someone’s eyeball, we have a big problem, right? That acid, we want to keep it in the stomach and the, you know, the past 20, 30 years, we’ve really been focusing on decrease the acidity, decrease the acidity. And yet, despite being on proton pump inhibitors, patients don’t necessarily get better the way we’d like them to. Right. So it’s not just about how acidic the environment is. Now you have to say, let’s try to find ways to keep the stomach acid in the stomach and then patients symptoms will get better.
Dr. Peter Belafsky [00:18:35] Which is one of the huge benefits of alginate therapy, right? We’re not altering the gastric page, we’re preventing regurgitation.
Dr. Ann Marie Barter [00:18:44] What’s the feeling to how much does a role of H. Pylori play in reflux?
Dr. Peter Belafsky [00:18:54] There’s actually been some work to suggest that H. Pylori is protective against gastroesophageal reflux disease, and some people see that the reflux pandemic, you know, it’s like over a quarter of the population now suffers from at least weekly heartburn. So people really think that the treatment of H. Pylori or the eradication of H. Pylori may have something to do with that. The issue is H. Pylori is also a primary cause of ulcers in the stomach and small intestine, as well as stomach cancer. So it’s sort of a trade off there. But, you know, certainly if H. Pylori is present with the vast majority of places, really recommend eradication of it.
Dr. Ann Marie Barter [00:19:43] And what’s your thought on that? You believe eradication is important? Do you believe it’s just important to get to the point where the patient has no symptoms, no ulcers, et cetera, where you guys that?
Dr. Peter Belafsky [00:19:58] You want to take it? I’m sure the yeah, I think if it’s really based on Andy’s findings at endoscopy, again, if there’s Emory, if there’s tissue injury, as you know, as a surgeon who sees cancer on a daily basis like my patients, at least my recommendation is let’s let’s treat this. Let’s get rid of this if they don’t have tissue injury. Then again, really, I’d like to find more natural ways of making their symptoms better because again, quality of life natural therapies are so effective at handling the symptoms. But if there is tissue injury, you know, then we treat
Dr. Ann Marie Barter [00:20:39] and the cancers that you’re seeing, I’m assuming, are esophageal and stomach. Is that correct? Throat and throat, as well as
Dr. Peter Belafsky [00:20:48] out of throat cancer, then?
Dr. Ann Marie Barter [00:20:49] So to the docs out there? My rule of thumb and you can correct me if I’m wrong, if I treating a patient and they are not improving and they’re continuing to have reflux in a pretty short period of time, then I send them out for for imaging. So basically scope to see what’s going on because cancer can be late stage. What’s your rule of thumb with that?
Dr. Peter Belafsky [00:21:19] I’m a tertiary referral center, so really everyone who comes to see me is likely to get it and ask me at some point, because that’s the only way we can tell definitively if there’s tissue injury. And like you mentioned, early gastric cancer, early esophageal cancer, early throat cancer is curable like know we catch an early esophageal cancer like that’s, you know, that’s a simple endoscopic ablation. But if it’s advanced, it’s terminal. So for us, if you have a young person who gets heartburn, they don’t have any swallowing problems. They’re not coughing. That’s a pretty low risk of cancer. But as soon as it’s really is forgetting stock is a huge danger sign for us and probably the most the most common warning sign that there’s tissue tissue injury.
Dr. Ann Marie Barter [00:22:16] Got it. That’s great. All right. So we’ve kind of talked about the common treatment methods. Should I leave much out of the common treatment methods?
Dr. Peter Belafsky [00:22:26] Yeah, I’m just good old and good old and assets like Toms, you know that buffer the page, you know?
Dr. Ann Marie Barter [00:22:35] And what are the concerns with being on terms long term? Because I know a lot of folks pop those like candy.
Dr. Peter Belafsky [00:22:40] Yeah, I’m from an I’m not really aware of any long term dangers. I guess it depends on, you know, if you drink enough water, it can be terminal, but I don’t know the right.
Dr. Ramon Franco [00:22:51] And also, some people will have problems with the calcium and you know, they can. They have a propensity for kidney stones and other things. And so it can it can cause a problem that way. But for me, the biggest, you know, I tell people all the time, you can you can pop Tums all day, but you know, you’re not getting to the underlying problem, you’re just basically masking something.
Dr. Ann Marie Barter [00:23:11] So let’s get to the underlying problem because I think that’s what probably everybody wants to know. So how is your approach different and what are you guys doing that is actually different because you have a company called reflux form, correct? Mm hmm. And so tell me how that approach is different than the standard approach that we generally see.
Dr. Peter Belafsky [00:23:34] You and take it.
Dr. Ramon Franco [00:23:35] Yeah, sure. So, like we were saying before, we want to keep stomach acid where it belongs in the stomach and for a while now. Actually, this is something that’s not brand new. Believe it or not, alginate are a natural substance that they form essentially a raft. You can think of it as like a gel raft that coats the stomach, goes on top of the stomach contents. And then when the stomach is churning, it helps to plug up the entrance to the esophagus so that you don’t have stomach contents moving up into the esophagus. So it’s a physical barrier to the movement of stomach contents into the esophagus.
Dr. Peter Belafsky [00:24:15] So I’ll just have to alginate therapy we call it of which reflux gourmet is all natural option. Alginate therapy is two primary effects. One is the demotion effect. Or actually, it’s very vicious and soothing, and it actually lines the mucus of the throat, the esophagus, even the stomach, and prevents tissue injury. We did a study in in rodents probably about 10 years ago where we took a carcinogen and put it on the mucosal lining and all the animals developed cancer. And then we took carcinogen and put the alginate down. And then we put the alginate down and then the carcinogen. And none of the animals developed cancer. So it has a known protective lining to the throat, esophagus, stomach. So that’s one of the mechanisms. The other mechanism, like Roman says, there’s bicarbonate and vitamin B5 in it, and the calcium and the vitamin B5 reacts with the alginate and the bicarbonate forms is foamy wrath. And it’s actually like an esophageal cork that actually prevents the regurgitation of the stomach contents back up into the esophagus and throat. So it’s actually does prevent reflux, unlike just this simple antacids. And one of the problems is that alginate, which is just Cowbridge, is just seaweed is really horrifically tasting, and Ramona and I were just lucky enough to have a patient who’s a Michelin rated chef. So we have Ken Franck, who is is actually the top truffle chef of North America. He’s the only
Dr. Ann Marie Barter [00:26:06] one I’ve heard of him. That’s exactly where I’ve heard of him. OK, that makes sense.
Dr. Peter Belafsky [00:26:10] He is the only chef in North America to be knighted by the Royal Order of the Knights of the Truffle.
Dr. Ann Marie Barter [00:26:19] Wow.
Dr. Peter Belafsky [00:26:20] And the science behind like just. Collecting truffles and hunting for truffles and the science behind truffles is amazing, so can can is like truly a wizard chemist, and he was able to to really make our alginate therapy be palatable and some people actually think it tastes good. And actually, we’ve had customers email us, actually put it on my ice cream.
Dr. Ann Marie Barter [00:26:50] Is that real? Because I am. Yeah. Wow. Yeah, because that has not been my experience. Yeah, that’s pretty good.
Dr. Peter Belafsky [00:27:00] Yeah, it’s a reminder. I’ve been really fortunate to be able to work with a world class chef who is our third partner.
Dr. Ann Marie Barter [00:27:08] So where did this idea come from? How did you guys come up with this?
Dr. Peter Belafsky [00:27:13] Well, algae therapy has been around for a long time. There’s got to be over. At least a dozen peer reviewed articles in the medical literature purporting the efficacy of alginate therapy. There just hasn’t really been an algae therapy product available in the United States, and our goal was to make an all natural one because the alginate can be very difficult to preserve for shelf life. So it took us like three to five years or something just to come up with a the right product. Not only was efficacious form this foamy esophageal of cork, if you will, but also tasted good.
Dr. Ann Marie Barter [00:28:04] So you do this supplement and you also are doing lifestyle changes. I’m assuming as part of the program, we talked about just shutting the kitchen off at six p.m. We’ve also talked about some of the foods that might contribute. Are there any other lifestyle changes that you guys address in your program?
Dr. Peter Belafsky [00:28:28] One big one, it was also just an ad elevator that had of the bad. But there’s also one thing we didn’t talk about. We could really just have a whole discussion on hiatal hernia. But you know, we talked about reflux is a normal physiologic mechanism, but a significant percentage of the population has what’s called a hiatal hernia, where the stomach protrudes above the diaphragm into the chest, where it doesn’t belong, it really belongs to the stomach belongs below the diaphragm. So there is actually a pouch of stomach in the chest that collects food and results in an incompetent lower esophageal sphincter and promotes regurgitation. So in patients with hiatal hernia, they’re sort of super reflux serves a really prominent regurgitation. And you know, there’s actually been we actually have some some chiropractors who treat hiatal hernia with some various maneuvers that have been shown to have some effect. There’s very effective surgical procedures to repair. Hiatal hernia or alginate therapy has been shown to prevent regurgitation reflux from in patients with hiatal hernia. But in patients with big hernia, they may require surgery. So if you really are a champion reflux or you regurgitation constantly have chronic cough tissue injury swallowing problems, higher hiatal hernia may really be the culprit.
Dr. Ann Marie Barter [00:30:01] Wonderful. And one last important question, how does caffeine and coffee play into this? Because that’s I love to hear people negotiate about coffee and chocolate. It’s my favorite Zell. We talk too much about caffeine, but we haven’t pulled about coffee directly.
Dr. Peter Belafsky [00:30:22] I take this one to remind you, mine.
Dr. Ramon Franco [00:30:24] Yeah, sure. As I drink my coffee here,
Dr. Peter Belafsky [00:30:27] I drink my coffee too. And this is my national foundation of swallowing disorders marked as I’m passionate about swallowing problems and reflux is one of the primary causes of swallowing problems. This is my spitting image for quitters. Mug for people have problems swallowing, but you know the. One of the issues about caffeine and I was sort of on I decided I was going to give up caffeine about 10 years ago because I was having problems with heartburn. I was also having a little bit of a rapid heartbeat. So, my God, I’m going to give up coffee now. I’m going to take the rest of the world with me. But I just decided to do this big research project to evaluate the effects of just black coffee on reflux. So we actually did a. Blinded study where we did and like wireless testing, so we put a capsule and clipped it in the esophagus of patients undergoing endoscopy, and it measures acid in the esophagus over a three day period. And we did a wash out, so patients had to give up coffee because, you know, caffeine can be in your system for a couple of days. So they had to give up coffee for four three days prior. And then on the first day of the study, once they had the capsule and they had three cups of hot water. And then on the second day, they had three cups of black coffee and we actually gave them a core ECG machine with just a pot of Pete’s black coffee, which is like a coffee and one. We learned two things. One is, it was really, really difficult to recruit for the study because nobody wanted to give up coffee for three days prior to the study, even if we were paying them to participate. But the ones you know who for the benefit of science, who did participate, they actually had less reflux on the day that they had three cups of black.
Dr. Ann Marie Barter [00:32:36] Totally different, totally different. Yeah.
Dr. Peter Belafsky [00:32:39] So we didn’t have enough patients to publish that, but know we do have some data to suggest that up to three cups of black coffee a day does not appear to be detrimental and may even have a protective benefit. So I’m big into the health benefits of black coffee. I think the problem is when you have these giant lattes, mochas and throw cream and sugar and everything else, totally a different story. But I think you’re fine with black coffee unless it causes symptoms and anything that bothers you on the way down you should avoid, but it’s not bothering you. There’s a lot of benefit.
Dr. Ann Marie Barter [00:33:16] Interesting. Not what I was expecting you to say. So that was that was. I’m glad I asked. So where can people find you if they want to get in touch with you
Dr. Ramon Franco [00:33:28] so they can find us on what we’re selling through Amazon right now, soon to be on Walmart? You can always find us at our Reflex Gourmet Mi.com website, so various ways to get us.
Dr. Ann Marie Barter [00:33:40] Awesome.
Dr. Peter Belafsky [00:33:41] Many apothecary in New York and we’re soon to be on the shelf in L.A..
Dr. Ann Marie Barter [00:33:48] Very good. Awesome. So we’ll put the links below so that people can easily click. And guys, thank you so much for being here. It’s been a pleasure. This just been a great conversation. I think you’ve really enlightened folks on on GERD specifically. So and a different way to treat it. So thank you so much for being here.
Outro [00:34:10] Thank you for listening to the Gut Health Reset Podcast. Please make sure you subscribe, leave a rating and a review. More people can hear about the podcast and hey, take a screenshot of this episode and tagged Dr. Anne Marie on Instagram or Facebook at Dr. Ann-Marie Barter. And for more resources, just visit Dr. Ann-Marie Barter.com.