Apple cider vinegar… for heartburn?

I’ve always thought it sounded counterintuitive to use an acid to alleviate indigestion, but the number of times I’ve heard people treat their symptoms of heartburn with apple cider vinegar is too large to count. So, I decided to look into whether this strategy works, and to do some investigation about the idea behind its use. To my surprise, there is no research published in medical journals that addresses using raw apple cider vinegar to treat heartburn, despite widespread use and recommendations from blogs and websites.

What is heartburn?

Heartburn is most commonly caused by stomach acid contents traveling up into the esophagus, the pipe that connects the mouth to the stomach. Unlike the stomach, the esophagus is not used to the presence of acid. The stomach acid irritates the esophagus, leading to several symptoms including throat clearing, burning sensation in the chest and neck, sour sensation in the mouth, cough, and bloating. It is not a pleasant feeling. It’s what we call GERD, or gastroesophageal reflux disease.

There are several reasons why gastric contents move up into the esophagus instead of going down to the bowel. The relaxation of the lower esophageal sphincter (LES), a valve that sits between the esophagus and the stomach, is the most common culprit. The LES is usually closed, creating a contained system to digest food. But it opens from time to time, to let air out in the form of belching. Reflux mostly happens when the valve relaxes too much, or too often. It allows not only gas but also gastric acid to move up, causing the discomfort.

There is a theory stating that what controls the LES is the stomach’s acidity. If for some reason the stomach is not producing enough acid, the muscles around the LES would relax, resulting in more reflux. However, the mechanism that controls this valve is much more complex than the level of gastric acidity. It involves a complex network of involuntary muscles and several different hormones and neurotransmitters.

Medications for heartburn

The gold standard to treat heartburn is to take an over-the-counter class of medications called proton pump inhibitors (PPIs) that reduce stomach acidity. Using these drugs will not prevent reflux, but can reduce inflammation in the esophagus, allowing it to heal. Avoid taking these medications for more than a month, unless recommended by your doctor. It is not unusual to become used to PPIs. After taking them for a few weeks it may be hard to wean off of them, because stopping can cause rebound symptoms. PPI side effects are minimal, but long-term use can cause osteoporosis, infections, and a decrease in the absorption of nutrients.

Antacids and medications such as ranitidine and famotidine (H2 blockers) may work well and have fewer side effects, but if these strategies do not make you feel better within a few weeks, it is a good idea to consult with your doctor. Although rare, heartburn could be a sign of other serious illnesses.

Self-help measures for heartburn

Another approach that may be quite effective and free of side effects is to change specific behaviors:

  • Avoid foods known to cause heartburn: coffee, chocolate, alcohol, fatty foods, tomato, spicy foods, and acidic foods.
  • Avoid lying down for at least two to three hours after a meal.
  • Eat small meals.
  • Lose weight if you need to.
  • Don’t smoke, and if you already do, try to quit.

But what about taking apple cider vinegar for heartburn? Since we have no data to support the effectiveness or safety of its use for heartburn, it’s probably a good idea to stick to drizzling this deliciousness on colorful salads for now.

Related Information: Cooling Heartburn

Comments:

  1. Dave

    My 2 cents here. The basic problem might be low acid. People suffering from allergies tend to have lower stomach acid at some point I think. So any efforts to increase acid will help. I agree that I myself am disappointed with doctors approach or lack of any. It’s often the suffering individuals who learn by their own observations. Atleast I’m convinced that allergies can cause different symptoms as we move through the different phases during allergy season. Find if your allergic to anything and avoid them. Think your digestive system gets little sluggish as more and more mucous run unto the stomach eventually needing more acid. This can cause hives, angioedema, heart burns etc.
    Again my 2 cents. Kudos to doctors for their earning their degree. I’m surprised how doctors can’t put two things together to solve the puzzle but instead relying on age old prescriptions like ranitidine for all heartburn like symptoms. To all sufferers, don’t give up.Be observant or write a journal and don’t blindly take the medicines prescribed. I have many times not taken meds prescribed as it feel right. Anywayz….. I haven’t tried ACV but I know that I need to avoid allergens, eat drink to stoke the stomach fire, exercise etc…. Cheers…. God bless…

  2. Sheldon Haversham

    Vinegar BEFORE eating:

    There are mixed reviews of using vinegar to combat GERD. There two methods people generally speak about. 1st they use vinegar when they feel an onset of acid reflux, again, some find relief while others do not. 2nd are those that take it after a large meal, some find relief while others do not.

    Most have neglected the use of vinegar preemptively. Try using about a tablespoon of vinegar in a shot glass with water about 10 -15 minutes before eating a meal. This method helps diabetics before eating a sugar/carbohydrate meal.

  3. Phil

    Thank you for the article. I have tried apple cider vinegar in the past and here are my personal recommendations:

    – preferably after a meal on a full stomach
    – preferably diluted
    – preferably in small doses
    – preferably to rinse your mouth with water after just in case it affects tooth enamel.

    As for the self-help measures you recommended, these are really good basics. Actually if a person follows them closely, they do remove a big part of heartburn.

    I’ve also personally been sleeping on wedge pillows. It’s not a cure in itself, but it lets you sleep well at night (if you can get used to it). They come in many shapes and forms. The idea it to let gravity keep the stomach acid from going into the esophagus. This site has an extensive guide on which one to choose. https://www.bestwedgepillows.com/

    Finally, i would like to see more research done on Intermittent Fasting (IF) and acid reflux. My experience is that, contrary to common belief of “drowning the acid in food” by eating small portions regularly, which actually increases the stomach acid by keeping the stomach “active”, fasting for about 14-17 hrs, ie. from 2 pm to 7 am (lunch to breakfast) gradually lets the stomach get used to the fact that there is no food coming in and hence decrease “acid production”.

  4. Walter R., Ph.D.

    “Since we have no data to support the effectiveness or safety of its use for heartburn, it’s probably a good idea to stick to drizzling this deliciousness on colorful salads for now.”

    Amazingly conflicted advice given here. While it’s okay to recommend the “gold standard ” PPI treatment, with a list of known, serious side effects, it’s not okay to suggest using a teaspoon or two of apple cider vinegar, a “natural” and inexpensive treatment, because there is no rigorous scientific evidence backing ACV. But it’s okay to sprinkle ACV on your salad.

    If you read the comments here, from many who have successfully used ACV, I would be tempted to give ACV a try before using any OTC remedy. In the absence of gold standard research, I would seriously consider the one-sided anecdotal evidence presented here and rely on the “Wisdom of Crowds”.

  5. Dr D

    I tried it for the supposed health benefits but it gave me heartburn.

  6. Maryalice Jordan-Marsh

    when discussing medications for heartburn, GERD, I think it is important to address the accumulating evidence that some of common medications seemed to be linked to earlier onset (trigger?) dementia.

  7. phung

    While the food is being digested, the larger amount of acid causes the heartburn. The apple cider vinegar is also an acid. Taking a swing of it may seem counterintuitive, but it works for many people. The extra acid causes the stomach to stop producing more stomach acid as a counter balance and helps to reduce the heartburn.

  8. Mary

    Agree with the following comment from azure and want to add that my husband took PPIs for years. He tried Apple Cider Vinegar due to the recommendation of a friend that it worked for. My husband’s heartburn and reflux is pretty well cured. He only has to drink the diluted apple cider vinegar a few times per month now after he has indulged in rich foods.

    “Maybe there’s been no research because it’s not possible to gouge people by raising the price of apple cider vinegar? Meaning it’d be difficult for a pharmecutical corporation to patent the process of making apple cider vin vinegar.

    That’s what happens when the feds no longer think any scientific research other then into weapons-related research is worth funding. There’s no funding for testing that won’t produce profits, and then, of course, it becomes imperative that the research results support the efficacy and safety of the corporate product.”

  9. fariman moghadassi

    I tried vinegar it helped my acid reflux but now I am taking probiotic it works even better for me.

  10. J Powderly

    So a whole article and not even a cursory description as to why so many people use apple cider vinegar for heartburn? The theory is those larger meals of rich food take stomach acid to start the digestive process. While the food is being digested, the larger amount of acid causes the heartburn. The apple cider vinegar is also an acid. Taking a swing of it may seem counterintuitive, but it works for many people. The extra acid causes the stomach to stop producing more stomach acid as a counter balance and helps to reduce the heartburn. I’m not a medical professional. So what do I know? I know that if Harvard Medical School puts a clickbait article on their site then it will tease away, just like a common hacker.

  11. Gramma

    When I have an upset stomach I often use a little acv (1-2teaspoons) in a glass of water. I used a little when glucose and cholesterol levels were up. Both improved. I am not regular about this but results were good for last labs.

  12. Mark Gostine, MD

    I am a physician (MD) with holistic inclinations. There is actually some literature on vinegar as a prebiotic, encouraging the growth of beneficial acid loving bacteria i.e. acidophilus.

  13. Pia Toaff

    The idea of using Apple cider vinegar agrees with what i have recently read and followed that to counteract acid re flux, drink a (mildly) acidic drink that will stop the re flux because the acid will already be there. For me it has worked with pure vitamin c powder. It is not a panacea in a bad case so I have started following the advice given here about not l lying down for a couple of hours after a big meal, reducing the size of meals, avoid fried foods, etc.

  14. Karolina

    If the simple measures are not sufficient, why not just try? What is the harm? The medicines have side effects. Some – rather serious. Apple cider vinegar? I don’t understand discouragement of trying it just because there are no scientific studies.

    Oh, and for the one who said there is no money to be made in this, apparently, there is — by making a chewing gum with vinegar and other stuff: https://www.ncbi.nlm.nih.gov/m/pubmed/25144853/ 🙂

  15. Cat

    Post gallbladder surgery can cause bile reflux . Heartburn remedies may relieve the “burn,” but no long term relief. The apple cider vinegar can counter the bile which is a base (the opposite of acid) and also causes “heartburn.” This is simple chemistry. It doesn’t need a study.

  16. Phil Dourado

    Well, that was a misleading headline. I thought you’d answer the question instead of saying “Apple cider vinegar Who knows?”

  17. Gretchen Saaduddin

    Exactly why I don’t go to doctors for the last 10 years, having been made sicker by each one of their suggestions (and I worked in medicine in a major university for 34 years). And this doc could have done his own mini trial to see how ACV actually works (because it does, and it doesn’t contribute to c-diff. vitamin deficiency, cognitive issues and a host of other problems as PPIs and other meds do). But that is the kind of inquiring mind medical schools are churning out to insure that the Big Pharma grant gravy train isn’t discontinued. Not all docs are mindless, but do research to check everything you are told. Maybe this guy’s blog was his attempt at giving us helpful info. while still remaining loyal to the “System”. At least he can get credit there.

  18. Mahmood

    I had hurtburn more than 10 years and I used all kind of OCT medications but it was useless until I tried ACV tablets within one month I’m okay Thank God.

  19. azure

    Maybe there’s been no research because it’s not possible to gouge people by raising the price of apple cider vinegar? Meaning it’d be difficult for a pharmecutical corporation to patent the process of making apple cider vin vinegar.

    That’s what happens when the feds no longer think any scientific research other then into weapons-related research is worth funding. There’s no funding for testing that won’t produce profits, and then, of course, it becomes imperative that the research results support the efficacy and safety of the corporate product.

  20. Alex

    What kind of vitamins you can recommend?

  21. Jahnavi

    Wow… This will be information help a little and can be homemade usage. Really the apple cider vinegar works on the heartburn.. did it prove practically.

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