Would you pour gasoline on a fire to put it out?
The answer, of course, is obvious. Then why would so many people take apple cider vinegar – which is extremely acidic – to treat acid reflux and heartburn?
It seems strange, to say the least. Adding even more acid to a stomach that’s already burning and pumping acid back up into the esophagus?
Many do indeed take apple cider vinegar for heartburn and the acid reflux that causes it. They have theories that justify it. And a good number of people claim it really does make them feel better.
The big questions, though, are whether it’s a proven treatment, and whether you should try it.
Let’s take a deeper dive into the science.
Heartburn, Acid Reflux, and GERD
Those three terms are often used interchangeably. Even though they’re related, however, they’re not the same. So let’s get the terminology straight before going any further.
- Acid Reflux: This is a medical condition, sometimes referred to as acid indigestion. It occurs when the contents of your stomach (including stomach acid) flow “backwards” and up into the esophagus, the tube that usually carries food down into the stomach. A sphincter (much like a valve) normally prevents that from happening, but acid reflux develops when there’s a problem with the sphincter.
- Heartburn: The burning sensation in your stomach and chest that we call heartburn is the primary symptom of acid reflux. Acid moving into the esophagus is what creates the burning sensation. Other acid reflux symptoms can include nausea and vomiting, bloating, upset stomach or indigestion, a nasty taste in the mouth and difficulty swallowing, but heartburn is the one most people notice first.
- GERD: Gastrointestinal reflux disease is the diagnosis doctors use when someone suffers acid reflux symptoms more than twice a week – generally making it a disease and not just an occasional response to eating a lot of spicy foods.
So acid reflux is the medical issue, heartburn is the symptom, and GERD is the description of a recurring problem with acid reflux. It’s quite common; the U.S. Department of Health and Human Services estimates are that one-in-five Americans suffer from GERD, and many more experience occasional heartburn.
Causes and Treatment of Reflux, Heartburn, and GERD
One major cause of acid reflux and GERD is what’s known as a hiatal hernia, a physical abnormality that pushes part of the stomach above the sphincter and diaphragm. There are a number of risk factors that can also contribute to acid reflux or GERD, though. They include lying down after eating, smoking, bedtime snacking, drinking alcohol, carbonated or caffeinated beverages, taking lots of NSAIDs like ibuprofen or aspirin, and eating spicy or acidic foods. Pregnant women and obese people are also more at risk.
Occasional acid reflux, and the heartburn it causes, can often be treated with lifestyle changes like quitting smoking, weight loss, eating smaller meals, avoiding “trigger” foods, waiting several hours after eating before lying down, and sleeping with your head elevated. Your doctor may also be able to suggest changes in medication that could be causing or worsening the problem.
Those who suffer from heartburn or other symptoms of acid reflux may first try natural remedies like chewing gum or drinking baking soda mixed with water. If those home remedies don’t work, they’ll run out to pick up antacids like Rolaids or Maalox, since they can ease heartburn symptoms by neutralizing at least some of the stomach acid that’s backing up into the esophagus. Some antacids do also cause secondary issues like constipation or diarrhea, though, so antacids that contain aluminum hydroxide and magnesium hydroxide are the best choices.
More serious cases of reflux and GERD are often treated with more powerful or prescription medications, as well as probiotics. According to Gut and Liver, the most commonly suggested meds are H2 blockers like Pepcid and Zantac, or proton pump inhibitors (PPI) like Aciphex and Prilosec. They all reduce stomach acid levels. In worst-case scenarios, surgery can permanently reduce or eliminate acid reflux problems.
But what about apple cider vinegar?
Apple Cider Vinegar and Heartburn
It’s been nearly impossible to miss the public discussion of proven and possible health benefits of apple cider vinegar.
ACV has been shown to help moderate blood sugar levels in diabetics, and has shown promise in the fight against causes of heart disease like high blood pressure and high cholesterol. There’s some (but very limited) evidence that it may ease some digestive disorders and even help fight cancer.
But its purported use to treat reflux leads to a number of reasonable questions. Why would acidic apple cider vinegar help with heartburn? Is drinking vinegar that’s loaded with acetic acid be a good idea to treat a medical condition characterized by irritation from stomach acid? Wouldn’t you want a solution that ensures that the digestive tract contains as little stomach acid as possible?
The answer from health experts is pretty much unanimous: you’re absolutely right. It makes no logical sense. And if you dig more deeply, there are no scientific studies or articles in medical journals that show any benefit to drinking ACV to treat heartburn or reflux. The only study that’s been cited anywhere is an Arizona State University graduate student’s thesis paper.
Then why do so many people do it?
Some holistic practitioners suggest ACV as a heartburn remedy, and offer several theories as to why it might work.
- They believe acid reflux can be caused by “bad” bacteria in the digestive system, and since acetic acid has proven anti-microbial properties, they claim ACV can kill those harmful bacteria.
- A small number of heartburn cases are caused by low stomach acid levels (medically known as a condition called hypochlorhydia, ironically often caused by taking too many PPIs), so some in the holistic world believe adding more acid via apple cider vinegar is an approach worth trying.
- Some also claim that introducing ACV’s acetic acid can help by balancing pH levels in the stomach, or that the pectins and enzymes in vinegar effectively treat heartburn.
Unfortunately, there’s absolutely no evidence that proves any of those theories. Of course, not much research into them has been conducted, either – so some might say the jury is still out, even though the experts think that apple cider vinegar is the wrong way to treat acid reflux or GERD.
They also point to the possible side effects of drinking ACV: damage to tooth enamel, delayed stomach emptying and associated digestive problems, drug interactions, and low potassium levels.
To put things simply, apple cider vinegar may help some heartburn sufferers – or at least, they may think it helps them. But there’s no medical evidence that it works, and there are much better solutions.