Some health benefits of apple cider vinegar are accepted throughout the medical community. For example, its effectiveness as an antibacterial agent and its ability to help control blood sugar levels in patients with type 2 diabetes are supported by studies published in respected medical journals.
At the other extreme are home remedies or fads which haven’t been tested or proven anywhere, and “treatments” which rely solely on animal studies or a single human study. Those include ACV’s supposed ability to lower blood pressure and the risk of heart disease, treat acne, ease sunburn, and even cure cancer.
Then there are uses for apple cider vinegar, such as producing rapid weight loss which make complete sense to holistic practitioners, but haven’t yet been proven to the satisfaction of medical experts.
Another treatment in that last category involves treating acid reflux by drinking diluted apple cider vinegar. The idea seems reasonable to some, but is completely discounted by medical experts because it hasn’t been proven by scientific studies; the only published research of any kind on ACV and reflux was a graduate student’s thesis. (1)
Hope or hoax? Let’s try to sort out the controversy.
What Is Acid Reflux?
Before discussing the cause of acid reflux, it’s important to understand the difference between the three terms often used to describe the burning sensation in the chest, throat or stomach we’ve all suffered when eating too much spicy food.
That sensation is heartburn, and it’s just a symptom of the medical issue known as acid reflux. The third term often used for the issue is GERD. That stands for gastrointestinal reflux disease and is used to describe cases of acid reflux which persist, occurring regularly more than twice per week. (Heartburn can manifest in other acid reflux symptoms including bloating, indigestion, nausea or vomiting, a sore throat or a bitter taste in the mouth.) (2)
So what we’re looking at here isn’t whether apple cider vinegar can ease a single incident of heartburn. We want to know if it can treat the actual cause of the problem, which is acid reflux.
The Causes of Acid Reflux
What causes reflux? Understanding the answer requires knowing a little about anatomy.
The tube that connects the mouth and the stomach is called the esophagus. The food we eat passes through the esophagus to get to the stomach, where it’s digested. And inside the esophagus is a valve, known as the lower esophageal sphincter (LES).
After you eat, the LES closes the sphincter so that food – and the stomach acid that digests it – can’t flow up the tube in the wrong direction. That’s an important function, because if stomach acid does back up it can irritate the esophagus, causing the pain we know as heartburn.
Why would that happen? It’s usually because a physical issue causes the sphincter to malfunction. That “leaves the valve open” and allows food and acid to travel back up into the esophagus. There are several different reasons why that can happen, but the phenomenon itself is known as acid reflux.
One reason the sphincter might not do its job properly is a hiatal hernia, which causes the top of the stomach to bulge into the diaphragm and push the LES out of place. Another is a condition which is, ironically, a side effect of taking proton pump inhibitors (PPIs) to treat reflux. It’s called hypochlorhydria, and it results in the body producing too little stomach acid.
There are other risk factors that can increase the chances that you’ll develop acid reflux, including obesity, pregnancy, smoking, eating large meals or too late at night, or taking a lot of NSAIDs. Specific foods and beverages, including fried foods and fatty foods, alcohol, and coffee, can also act as triggers for some people.
The symptoms of acid reflux and GERD are initially treated in two ways: lifestyle changes (eliminating risk factors and any triggers which can be identified), and using either antacids or home remedies (chewing gum, drinking water with baking soda) to relieve occasional heartburn symptoms.
If the problem continues or the esophagus is inflamed, however, doctors use OTC or prescription medications. Some slow down the production of stomach acid (H2 blockers), and others heal the esophagus and block acid production (the PPIs we mentioned earlier). In the most difficult cases, surgery may be recommended.
How Apple Cider Vinegar Fits Into the Picture
There are three reasons why apple cider vinegar might – theoretically – help ease acid reflux and heartburn.
We’ve already touched on one of them. A possible cause of acid reflux is the low stomach acid levels created when people take PPI medications – and the most important active ingredient in ACV is acetic acid. Some who believe apple cider vinegar helps relieve acid reflux argue that the acid in ACV (importantly, it must always be diluted) will boost the level of stomach acid in the digestive tract, reducing the problem considerably.
Here’s the second reason. One of the universally-accepted health benefits of apple cider vinegar is that it has strong antibacterial properties, and malicious bacteria can cause a number of problems in the digestive system. That doesn’t mean ACV is a golden ticket that will cure all digestive orders, but it’s been shown to be as effective as prescription medication in killing several types of bacterial infections in the gut and bowel. (3)(4)
Finally, there are other beneficial ingredients in apple cider vinegar which generally help with gut disorders. The pectin contained in apples is one of the natural remedies sometimes used to treat acid reflux and GERD (5), and the “mother” that’s created when apples are fermented into ACV is believed to contain healthy amounts of probiotics which can boost the immune system and help with digestion. You should be aware that the latter only happens when you’re drinking unfiltered, raw apple cider vinegar; clear, filtered vinegar has had the mother removed.
How to Treat Acid Reflux With ACV
There’s good news: whether or not you believe the supposed science or the medical experts, there’s very little to lose if you want to try treating your acid reflux with apple cider vinegar.
There are a few possible side effects if you try and drink the ACV without diluting it sufficiently; you could damage your tooth enamel, burn your mouth and throat, or make your heartburn worse. And the vinegar can interfere with some prescription medications – so talk to your doctor first. But for most people, there’s no risk in trying this recipe.
Simply mix a teaspoon of organic apple cider vinegar with warm water, and drink it before or after meals. (Organic vinegar isn’t a necessity, but it’s healthier.)
The ACV doesn’t help? No harm, no foul. But if it does, you’ve found an easy way to deal with the often-painful symptoms of acid reflux.